NG Tube Insertion and Tube Feeding

Question 1

How to measure NG tube to determine proper length for insertion

Answer 1

put tube at tip of nose
back to earlobe
down to xiphoid process
mark that with a piece of tape

Question 2

How to position the pt’s head during NG tube insertion

Answer 2

the neck should be hyperextended when you first start to insert the tube

once you feel resistance or the pt begins to gag, you’ve hit the pharynx

pt can bring head forward and take sips of water if able (because swallow motion will help push tube down farther)

Question 3

List supplies needed to insert an NG tube (10)

Answer 3

NG tube
Lopez valve
water-soluble lubricant
gloves
tape
commercial securement device (if available)
safety pin
60 mL slip tip syringe
pH strips to test pH of gastric contents
glass of water

Question 4

What is the best practice for confirming NG tube placement?

Answer 4

checking gastric pH (1-5)

Question 5

How is NG tube placement confirmed at Blessing?

Answer 5

injecting air (30 mL) and listening for bubbling sound over stomach

air bolus

Question 6

Two ways to secure NG tube

Answer 6

secured to nose with tape
secured to gown with flag of tape and safety pin

Question 7

When removing NG tube, why is air inserted into the tube prior to removal?

Answer 7

to clear the tube of any secretions, tube feeding, or anything else that may be in the tube

you use air so that the tube will be dry at the end

Question 8

What should the pt do while the NG tube is being removed?

Answer 8

take a deep breath and hold it to protect the airway and prevent aspiration

Question 9

Three reasons a pt may need a NG tube

Answer 9

client is unable to ingest foods
upper GI tract is impaired but remainder of intestinal tract is functional
unconscious

Question 10

What position must a patient be in prior to tube feeding?

Answer 10

Fowlers because it enhances gravitational flow of the solution and prevents aspiration of fluid into the lungs

Question 11

After doing your AIDET, verifying your patients identity, performing hand hygiene, and properly positioning your patient, what are the next 2 steps that are performed PRIOR to administering a tube feeding?

Answer 11

check the pt’s residual and tube placement confirmation (air bolus)

Question 12

What type of tubing is used for bottle of tube feeding?

Answer 12

spike set tubing

Question 13

What type of tubing is used for a can of tube feeding?

Answer 13

top fill tubing

Question 14

If you are using the top-fill tubing, how many hours’ worth of tube feeding can be added to the bag at one time?

Answer 14

8 hours

Question 15

How long can the tubing be used before it must be changed?

Answer 15

24 hours

Question 16

When setting the feeding pump for a continuous tube feeding, what is the flush set at in mL per hour? (Blessing Hospital policy)

Answer 16

25 mL per hour

Question 17

At Blessing Hospital, how often are residuals checked for patients receiving continuous tube feeding?

Answer 17

Every 4 hours for the first 48 hours until goal rate is achieved, then check every 6 hours

Question 18

At Blessing Hospital, how often are residuals checked for patients receiving bolus tube feeding?

Answer 18

before each feeding

Question 19

Describe the rationale for checking the residual on a patient with a continuous tube feeding.

Answer 19

This determines adequate absorption and verifies correct placement of the tube.

Question 20

A patient at Blessing Hospital has a continuous tube feeding. The residual amount is 550 mL Describe the actions the nurse must take at this time.

Answer 20

Stop the feeding and call the physician.

Question 21

How much flush is given prior to and after administering a bolus tube feeding? Describe the rationale for flushing the tubing before and after feedings.

Answer 21

The amount of flush given is 30-60 mL because water flushes the lumen of the tube, preventing future blockage by sticky formula.

Question 22

Since a pump is not used with a bolus tube feeding, how is the feeding administered?

Answer 22

Take the plunger off of a syringe and pour the feeding in the tube of the syringe. (uses gravity)