Nasogastric Tube (NGT) Insertion Quiz

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Questions and Answers

Which of the following is NOT a purpose/indication for a nasogastric tube?

  • Relief of symptoms and bowel rest in small-bowel obstruction
  • Administration of medication
  • Feeding
  • Treatment of esophageal tumors (correct)

Which condition is a contraindication for the insertion of a nasogastric tube?

  • Baseline skull fractures
  • Actively bleeding oesophageal
  • A history of nasal surgeries
  • Chronic stomach pain (correct)

What is one of the main complications that can result from NG tube insertion?

  • Hypertension
  • Esophageal perforation (correct)
  • Increased appetite
  • Acid reflux

Which practitioner can commonly insert nasogastric tubes?

<p>Doctors, nurses, and allied health professionals (B)</p> Signup and view all the answers

How can the position of an NG tube be confirmed?

<p>By using pH indicator paper on NG aspirate (C)</p> Signup and view all the answers

What should you do if the pH reading of the nasogastric tube aspirate is more than 5.5?

<p>Consult the healthcare team and do not administer anything down the nasogastric tube (B)</p> Signup and view all the answers

What is the purpose of the syringe test (whoosh test) in confirming the placement of a nasogastric tube?

<p>The syringe test (whoosh test) is an unreliable method and should no longer be used to confirm nasogastric tube placement (C)</p> Signup and view all the answers

What is the purpose of performing a chest X-ray to confirm the placement of a nasogastric tube?

<p>To visually confirm the position of the nasogastric tube and ensure it is not coiled or misplaced (A)</p> Signup and view all the answers

What is the recommended procedure for checking the placement of a nasogastric tube using the pH test?

<p>Gently withdraw aspirate along the length of the nasogastric tube into the syringe, and if the reading is more than 5.5, do not administer anything down the tube and consult the healthcare team (D)</p> Signup and view all the answers

What is the recommended method for confirming the placement of a nasogastric tube?

<p>Performing a chest X-ray to visually confirm the position of the nasogastric tube (C)</p> Signup and view all the answers

Flashcards

NG tube: Non-indication

The treatment of esophageal tumors is not a typical indication for a nasogastric tube.

NG tube: Contraindication

Chronic stomach pain is a contraindication for NG tube insertion.

NG tube: Main complication

Esophageal perforation is a major complication of NG tube insertion.

Who inserts NG tubes?

Doctors, nurses, and allied health professionals can insert NG tubes.

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Confirm NG tube position

pH indicator paper is used on NG aspirate to confirm placement.

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NG tube Aspirate pH > 5.5

If the pH reading of the NG aspirate is more than 5.5, consult the healthcare team and do not administer anything via the tube.

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Syringe test (whoosh test)

The syringe test (whoosh test) is unreliable for confirming NG tube placement and should not be used.

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Confirm placement with...

A chest X-ray is used to confirm the position of the NG tube and ensure it is not misplaced.

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NG placement check

Check aspirate pH; if it exceeds 5.5, withhold administration and seek medical advice.

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Best confirmation method

Confirm NG tube placement by chest X-ray to verify its position.

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Study Notes

Nasogastric Tubes (NGT)

  • A nasogastric tube (NGT) is inserted through the nose, into the stomach via the esophagus for diagnostic and therapeutic purposes.
  • NGT comes in various sizes (8, 10, 12, 14, 16, and 18 Fr).

Purpose and Indications

  • Feeding
  • Administration of medication
  • Bowel irrigation
  • Decompression of the stomach to remove gas and fluid
  • Relief of symptoms and bowel rest in case of small-bowel obstruction
  • Aspiration of gastric content from recent ingestion of toxic material

Contraindications

  • Basal skull fractures
  • Nasal/pharyngeal/oesophageal obstruction or ulceration
  • Gastroparesis (partial paralysis of the stomach)
  • Laryngectomy
  • Esophageal tumor or surgery
  • Actively bleeding oesophageal
  • Unstable Cervical Spinal injuries

Complications

  • Aspiration and tissue trauma
  • Placement of the catheter can induce gagging or vomiting, Patient discomfort
  • Epistaxis
  • Pulmonary complications
  • Esophageal perforation

Confirming NG Tube Position

pH Indicator Method

  • Attach a syringe to the end of the tube and aspirate a small amount of stomach contents (at least 0.5-1ml).
  • If the pH reading is more than 5.5, DO NOT administer anything down the nasogastric tube and consult the healthcare team.

Chest X-ray Method

  • A chest X-ray can be used to confirm the safe placement of an NG tube if pH testing is not possible.
  • Some hospitals may require a chest X-ray to confirm the safe placement of all NG tubes, regardless of the NG aspirate results.

Syringe Test (Whoosh Test) - Unreliable Method

  • This method involves air injection through the tube, and if the air is heard in the stomach with a stethoscope, it is assumed the tube is in the correct position.
  • The absence of gurgling suggests the tip of the NGT is elsewhere (lung, esophagus, pharynx).
  • This method is no longer recommended due to its unreliability.

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