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What is the primary purpose of inserting a nasogastric tube?
What is the primary purpose of inserting a nasogastric tube?
Which condition is NOT indicated for the use of a nasogastric tube?
Which condition is NOT indicated for the use of a nasogastric tube?
What is the correct body position for a pediatric patient during nasogastric tube insertion?
What is the correct body position for a pediatric patient during nasogastric tube insertion?
What is one of the first steps in the nasogastric tube insertion procedure?
What is one of the first steps in the nasogastric tube insertion procedure?
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How should the nasogastric tube be inserted when it reaches the pharynx?
How should the nasogastric tube be inserted when it reaches the pharynx?
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What should be done to assess the placement of the nasogastric tube after insertion?
What should be done to assess the placement of the nasogastric tube after insertion?
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In which situation should the nasogastric tube be removed?
In which situation should the nasogastric tube be removed?
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What should be monitored after the insertion of a nasogastric tube?
What should be monitored after the insertion of a nasogastric tube?
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Study Notes
Nasogastric Tube (NGT)
- Definition: A medical procedure involving inserting a thin, flexible plastic tube through the nose, esophagus, and into the stomach.
- Alternative: Orogastric Tube (OG) is similar, but the tube enters through the mouth.
- Purpose: Used for drainage, diagnostics, therapeutics, and feeding.
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Indications for use:
- Unable to take oral feedings.
- Oral surgery (e.g., cleft lip/palate, jaw fracture).
- Difficulty swallowing.
- Malnutrition.
- Premature babies.
- Vomiting/anorexia nervosa.
- Aspiration of gastric contents (e.g., poisoning).
- Medication administration.
- Unconsciousness.
- Endotracheal intubation.
Equipment
- Kidney tray: For collecting waste.
- Cotton-tipped applicators: For cleaning nostrils.
- Ryle's tube: Used for feeding or drainage.
- Lubricant (water-soluble jelly or glycerin): To prevent friction.
- Scissors: For cutting.
- Adhesive plaster or tape: For securing.
- Measuring cup/glass: For measuring feed amounts.
- Sterile syringe (10-20 mL): For aspirating contents or administering medications.
- Paper bag: For collecting waste.
- Glass of warm water: To warm feed to body temperature.
- Tongue blade: Used for examination.
- Suction apparatus: To clear airways as needed.
- Bowel with water: To check NG tube placement.
- Clamp: To prevent leakage of gastric contents.
Pediatric Positioning
- Supine: Lying flat.
- Head elevated: Bed head elevated 30-40°. Options are sitting upright for older children.
- Infant/younger child holding: Requires parental consent.
Procedure
- Identify the child.
- Explain the procedure.
- Make the patient comfortable.
- Position a face towel: Across the chest and under the chin.
- Keep a kidney tray ready: For vomit.
- Clean the nostrils.
- Assemble supplies properly.
- Proper hand washing.
- Check tube patency.
- Measure placement: From nose tip to xiphoid process.
- Lubricate the tube.
- Insert slowly: Give sips of water and guide with swallows (adjust amount to child's age)
- Check placement: Aspirate stomach contents and check pH. X-ray is an option.
- Monitor input/output.
- Remove the tube: If blockage occurs or if no longer needed.
Oral Hygiene
- Frequency: Every 4-6 hours.
- Purpose: Prevents infection.
Non-Radiological Verification of Placement
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pH test: Aspirate 2 mL of stomach contents, and test using pH paper.
- pH ≤5.5 indicates correct placement
- pH >5.5 requires radiology confirmation
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Gastric auscultation: Using a syringe, inject 3mL of air, while listening with a stethoscope.
- If you hear whooshing, gurgling, or popping sounds, the tube is correctly positioned.
Contraindications
- Gastric surgery.
- Ulcers.
- Tracheo-esophageal fistula.
- Esophageal surgery
- Recent nasal/facial surgery
- Polyps in nose
- Deviated nasal septum
- Patient on anticoagulant therapy.
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Description
This quiz covers the fundamentals of the nasogastric tube (NGT) procedure, detailing its definition, purpose, indications for use, and necessary equipment. Test your knowledge on how NGT is utilized for feeding, drainage, and medication administration in various clinical situations.
