Nasoenteric-Decompression Tube Insertion and Removal
The nasoenteric-decompression tube is inserted nasally and advanced beyond the stomach into the intestinal tract. It’s used to aspirate intestinal contents for analysis and to treat intestinal obstruction. The tube may also help to prevent nausea, vomiting, and abdominal distention after GI surgery. The doctor usually inserts or removes a nasoenteric-decompression tube; however, the nurse may remove it in an emergency.
The nasoenteric-decompression tube may have a pre-weighted tip and a balloon at one end of the tube that holds air or water to stimulate peristalsis and facilitate the tube’s passage through the pylorus and into the intestinal tract. (See Common types of nasoenteric-decompression tubes.)
Equipment
For Insertion
Nasoenteric-decompression tube ▪ suction-decompression equipment ▪ gloves ▪ towel or linen-saver pad ▪ water-soluble lubricant ▪ 4″ × 4″ gauze pad ▪ hypoallergenic tape ▪ bulb syringe or 60-mL catheter-tip syringe ▪ pH test paper ▪ penlight, as needed ▪ waterproof pen ▪ glass of water with straw ▪ Optional: labels for tube lumens, basin of ice or warm water, local anesthetic.
For Removal
Sterile 10-mL syringe ▪ gloves ▪ towel or linen-saver pad ▪ clamp.
Preparation of Equipment
Before insertion, stiffen a flaccid tube by chilling it in a basin of ice to facilitate insertion. To make a stiff tube flexible, dip it into warm water.
Air or water is added to the balloon either before or after insertion of the tube, depending on the type of tube used. Follow the manufacturer’s recommendations.
Set up suction-decompression equipment, if ordered, and make sure it works properly.
Implementation
Verify the doctor’s order.
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.1
Explain the procedure to the patient, forewarning him that he may experience some discomfort. Answer all questions to decrease anxiety and increase cooperation.
Provide privacy and adequate lighting.
Position the patient as the doctor specifies, usually in semi-Fowler’s or high Fowler’s position. You may also need to help the patient hold his neck in a hyperextended position.
Protect the patient’s chest with a towel or linen-saver pad.
Inserting A Nasoenteric-Decompression Tube
Agree with the patient on a signal that can be used to stop the insertion briefly, if necessary.
The doctor assesses the patency of the patient’s nostrils. To evaluate which nostril has better airflow in a conscious patient, he holds one nostril closed and then the other as the patient breathes. In an unconscious patient, he examines each nostril with a penlight to check for polyps, a deviated septum, or other obstruction.
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