NASOGASTRIC TUBE CARE
Providing effective nasogastric (NG) tube care requires meticulous monitoring of the patient and the equipment. Monitoring the patient involves checking drainage from the NG tube and assessing the patient’s gastrointestinal (GI) function. Monitoring the equipment involves verifying correct tube placement and irrigating the tube to ensure patency to prevent mucosal damage.
Specific care measures vary only slightly for the most commonly used NG tubes: the single-lumen Levin tube and the double-lumen Salem sump tube.
Essential Documentation
The nurse needs to:
Record the date and time that care was provided.
Regularly record tube placement confirmation (usually every 4 to 8 hours).
Record fluids instilled in the NG tube and any NG output. This may be recorded on an intake and output flow sheet.
Describe the NG drainage, noting its color, consistency, and odor.
Track the irrigation schedule and note the actual time of each irrigation.
Describe the condition of the patient’s skin, mouth, and nares as well as care provided.
Record tape changes and skin care provided.
Chart the assessment of bowel sounds.
Note any patient teaching provided by the nurse.
NASOGASTRIC TUBE INSERTION
Usually inserted to decompress the stomach, an NG tube can prevent vomiting after major surgery. An NG tube is typically in place for 48 to 72 hours after surgery, by which time peristalsis usually resumes. However, the NG tube may remain in place for shorter or longer periods, depending on its use.
The NG tube has other diagnostic and therapeutic applications, especially in assessing and treating upper GI bleeding, collecting gastric contents for analysis, performing gastric lavage, aspirating gastric secretions, and administering drugs and nutrients. Insertion of an NG tube demands close observation of the patient and verification of proper tube placement.
Essential Documentation
The nurse needs to:
Record the type and size of the NG tube inserted; the date, time, and route of insertion; and confirmation of proper placement.
Describe the type and amount of suction, if applicable; the drainage characteristics, such as amount, color (e.g., green, or coffee-ground), character, consistency, and odor; and the patient’s tolerance of the insertion procedure.
Include signs and symptoms signaling complications, such as nausea, vomiting, and abdominal distention.
Document subsequent irrigation procedures and continuing problems after irrigations.
