NG tube insertion and types
To determine the length of the tube for an adult, the nurse measures from the tip of the nose to the earlobe, then to the xiphoid process, and finally adds this many centimeters.
15.2 cm (6 inches
This is the only reliable method to confirm the initial placement of an enteral feeding tube.
radiographic (X-ray) confirmation
To reduce the risk of pulmonary aspiration, the head of the bed must be maintained at a minimum of 30 degrees, though this higher angle is preferred
45 degrees
A sudden weight gain of more than this amount in 24 hours usually indicates that the patient is experiencing fluid retention.
2 pounds
During the removal of an NG tube, the nurse should instruct the patient to perform this respiratory action to prevent aspiration.
taking a deep breath and holding it
This specific type of NG tube features a "blue pigtail" that acts as an air vent to prevent the suctioning of gastric mucosa.
Salem Sump tube
for a patient who has fasted for at least 4 hours, the pH of gastric fluid withdrawn from the tube should typically be at or below this value.
5.0
In an open system, the maximum hang time for enteral formula is generally limited to this many hours.
4 to 8 hours
If a patient develops nausea and vomiting, it may indicate this condition, requiring the nurse to withhold feedings and notify the provider.
paralytic ileus (or gastric ileus)
When inserting a feeding tube in an infant, the nurse must monitor for this type of stimulation, which can result in a decreased heart rate.
vagal stimulation
Unless contraindicated, this is the preferred upright position for a patient during the insertion of a nasogastric tube.
High Fowler’s position
This method of checking tube position, involving the injection of an air bolus, is considered unreliable and unsafe as a standalone verification technique.
auscultation
When managing a clogged enteral access device, the nurse should first attempt to clear the obstruction using this simple fluid with a back-and-forth motion.
warm water
Fever, shortness of breath, and pulmonary congestion are clinical signs that a patient may have experienced this serious complication.
pulmonary aspiration
In older adults, these two conditions may increase the risk of discomfort during tube insertion due to decreased secretions.
oral and nasopharyngeal mucosal drying
Nurses are strictly alerted never to reposition an NG tube in patients who have undergone this specific type of medical procedure to avoid rupturing suture lines.
gastric surgery
For patients on continuous tube feeding, the nurse should verify tube placement at this minimum frequency.
every 4 hours
This is the only type of fluid that should be used for flushing to prevent clogging and ensure medication effectiveness.
purified or sterile water
If a water flush fails to clear a clogged tube, the nurse may use a mixture of water, sodium bicarbonate, and this type of tablet.
uncoated pancreatic enzyme
To ensure gastric placement in children, the nurse adds half the distance from the xiphoid process to this anatomical landmark.
umbilicus
When inserting the tube, the nurse should have the patient perform this action after the tube passes the nasopharynx to help facilitate its passage into the esophagus.
bending the head toward the chest and/or swallowing
A large increase in Gastric Residual Volume (GRV) may indicate that a small bowel feeding tube has been displaced in this direction.
upward into the stomach
This specific type of connector is being phased in for all enteral equipment to enhance safety and prevent accidental tubing misconnections.
ENFit connector
This safety protocol involves tracing tubes from the patient to the source and routing IV lines toward the head while enteric lines are routed in this direction.
toward the feet
This is the standard volume of solution used for irrigating feeding tubes in neonates.
1 mL or less