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Nasogastric & Gavage - Nso
Nasogastric & Gavage - Nso
Nasogastric & Gavage - Nso
College of Nursing
NURSING SKILLS OUTPUT
Definition
Nasogastric Tube is a long, skinny tube that goes through the nose, down the
throat and into the stomach. These tubes are held in place by pieces of tape on the
cheek. They are used for giving someone extra nutrition by carrying food, and giving
medicine to the stomach through the nose. Gavage feeding is the method of giving
fluids, nutrients, or medications with the use (insertion) of the Nasogastric tube inserted
through the nose and into the stomach when the oral intake is inadequate or impossible.
Purpose
The purpose of this is for children who are unable to take food orally, by bottle or
breastfeed, who are undergoing oral surgery like cleft lip or cleft palate, fracture of jaw,
and dysphagia. Moreover, this is for conditions that are not supportive to take large
amount of good orally such as severe burns, malnutrition, prematurity of babies, acute
and chronic infections, and conditions when patient is unable to retain food such as
anorexia nervosa and vomiting.
Objectives
Equipment
PROCEDURE
1. 'Confirm patient’s identity using two patient identifiers according to your facility’s
policy.
Rationale: To administer gavage feeding to the right patient.
3. Prepare the patient (parents if the patient is baby) by providing the necessary
information and education and by offering reassurance and inquire for medical
history.
Rationale: Education increases the patient's understanding of the
procedure and the reason for it.
5. Provide safe and comfortable position to patient (sitting on a chair or bed), and
place mackintosh and face towel across chest.
Rationale: To provide comfort throughout feeding and catch any spills of
the feeding.
6. Remove dentures, clean nostrils and check their patency by asking patient to
breathe through the other nostril.
Rationale: To provide better airflow during feeding.
9. Next is to, measure the distance on the tube from the bridge of the nose to the
ear lobe plus the distance from the ear lobe to the tip of the xiphoid process of
the sternum. Then mark the distance of the tube.
Rationale: To provide guide to determine estimate length of the tube to reach
the stomach.
10. Then, lubricate the tube for about 6 to 8 inches with the lubricant, using a rag
piece or a paper square. Lubricant should be applied to the minimum.
Rationale: This is to reduce friction between mucus membrane and the
tube. Excess lubricant can cause respiratory distress.
11. Hold the tube coiled in the right hand and introduce the up into the left nostril.
Rationale: The nasal septum is deviated into the right side.
12. Pass the tube gently but quickly backwards and downwards. There will be
momentary resistance that may occur as the tube is passed into the
nasopharynx. Assist the client to flex the head. Withdraw the tube about one
inch, rotate it side to side and gently advance the tube.
Rationale: Flexing of the head helps to flex the tube at the
nasopharyngeal junction and the tube enters the pharynx. Stop if there
is marked resistance and inspect the posterior cavity for coiled tubing.
13. When the tube reaches the pharynx, instruct that the client may gag. Allow him
to rest for a moment. Ask him to take panting breaths.
Rationale: Panting reflexes the pharynx. A brief pause may prevent vomiting.
14. Assist the client take sips of water and swallow on command. Advance the
tube 3 to 4 inches each time client swallows. Continue to advance the tube until
it reaches the previously designated mark.
Rationale: The act of swallowing facilitates the entering of the tube
through the esophagus. Mark on the tube indicates the tube has
reached the stomach.
15. Presence of excessive gasping, coughing and cyanosis are signs of respiratory
distress. The tube may be in the trachea. Immediately pull it out. Check the
placement of the tube in the stomach. Aspirate for gastric contents using a
syringe.
Rationale: Since fluids cannot be freely aspirated from the lungs.
16. Place the end of the tube with a syringe barrel or funnel into the bowl of water
and note the rhythm of escaping bubbles.
Rationale: If the tube is in the trachea, air bubbles will coincide with the
expiration of each breath.
3. When inserting the nasogastric tube, place your other hand behind patient’s
head.
Rationale: To prevent the patient from pulling back and for proper head support.
5. Have client remain in upright position for at least 30 minutes after feeding.
Rationale: This position minimizes risk of backflow and discourage aspiration should
any vomiting occurs.
Illustration:
____________________________________
Clinical Instructor
References:
https://www.msdmanuals.com/professional/gastrointestinal-disorders/how-to-do-gastrointestinal-
procedures/how-to-insert-a-nasogastric-tube
https://intermountainhealthcare.org/ckr-ext/Dcmnt?ncid=529856978
https://www.canestar.com/tube-feeding--gastric-gavage----nursing-procedure-and-responsibility.-.html
https://rnspeak.com/gastric-gavage-tube-feeding/