PAMANTASAN NG LUNGSOD NG

MAYNILA
(University of the City of Manila)
General Luna Street comer Muralla Street Intramuros,
Manila

COLLEGE OF NURSING
(Dalubhasaan ng Narsing)

MATERNAL and CHILD NURSING II

SKILLS LABORATORY CHECKLIST
INSERTING A NASOGASTRIC TUBE/OROGASTRIC TUBE

Name: ________________________ Date: __________

Year Level and Block: ___________ Clinical Instructor: ___________

Rating scale:

4- Performed correctly , systematically according to standard with correct

3- Performed correctly , systematically but with inadequate/incorrect rationale.
2- Performed correctly , not systematically with inadequate/incorrect rationale.
1- Performed incorrectly/not done.

Purpose
A nasogastric tube/orogastric tube may be used to:
1. Decompress the stomach
2. Feeding & Administration of medications
3. Assess gastrointestinal function.
4. Prevent aspiration & vomiting
5. Improve ventilation
Equipment/Materials needed:
• Nasogastric tube/Orogastric tube • Gloves, nonsterile (exam)
• Water-soluble lubricant • Pacifier, if suitable
• ½-inch tape • Emesis basis
• 1 transparent dressing • Pin and rubber band
• Syringe • Towel
• 1 hypoactive dressing • Stethoscope
• Blanket for restrain, if appropriate • Ph strips
Guidelines
Type of tube
- For gavage or lavage, use a single lumen tube.
- For intermittent gastric decompression, use a double lumen tube.
- For continuous long-term feeding, use a silicone tube.
Tube size
Weight of child Size
2 kg 5 French
3-9 kg 8 French
10-20 kg 10 French
20-30 kg 12 French
30-50 kg 14 French
>50 kg 16 French
 Implementation of the procedure:

Performance Remarks/Suggestion
Procedure/Steps 3 2 1 0 DEMERIT
1. Check Doctors order
2. Determine if the patient meets the criteria
for orogastric tube (OGT)/ Nasogastric tube
(NGT) placement. Assess the patient’s
mouth or nose for anatomic abnormalities
and secretions and perform an abdominal
assessment
3. Explain the procedure to the child Family.
Obtain a consent.
4. Prepare the equipment/materials
needed.
a. Select appropriate size and type of
NGT/OGT.
Note: Some guidelines are presented
above; however, the nurse must use his or
her judgment or follow agency policies.

5. Do handwashing and put on clean gloves

6. Introduce yourself and verify the client’s
identity using identifiers.
7. Place child supine at a 30-45 degree
angle if possible.
8. Measure length of tube to be inserted
and mark tube with a piece of tape. Several
methods of measuring length of nasogastric
tube to be inserted have been identified.
a. Measure from tip of to the nose to
the earlobe and from the earlobe to
the lower end of the xyphoid (or
point halfway between xyphoid &
umbilicus)
b. For OGT measure from the corner
of the mouth or lips to the lower
edge of the earlobe to a point
midway between the xiphoid
process and the umbilicus
9. Put a towel over the child’s chest and
hypoallergenic tape on the cheek
10. Lubricate 1 to 3 inches of the tube with
water or water-soluble gel.
11. Keep the child head straight and insert
tube gently into the nostril/ mouth; advance
using gentle pressure.
a. If resistance is met, withdraw the
tube a little and forward again.
12. If the child is able, ask child to swallow
as the tube is advance.
a. A pacifier may be used for an infant
over 3 months of age who does not
need to mouth breathe.
Continue to advance the tube until the tape
mark is at nostril/mouth.

13. Assess back of the mouth for kinking of

tube.

14. Remove tube immediately if there is

vomiting, signs of respiratory distress such
as cyanosis, tachypnea, nasal flaring,
grunting, wheezing, and prolonged
coughing or choking or if the child is unable
to speak or cry.
15. Remove guide wire if applicable.
Note: Some agencies have policies that
limit insertion of nasogastric tubes with
guide wires to physicians. Follow agencies
policy.
16. Double check placement of NGT/OGT
per agency policy. The literature identifies
several methods for air, withdrawal of
gastric/intestinal contents, checking
contents withdrawn for pH and other
characteristics, and inserting end of tube in
the water and watching for bubbles.
a. Research has demonstrated that
listening for air (a frequently
identified method) is the least
reliable method.
Note: The most reliable method for
confirming placement is x-ray.
17. Place hypoallergenic dressing on
child’s cheek/ side of mouth to secure the
tube
The NGT also may be taped to the upper lip
or nose.
Use a 4-inch length of tape, split about 2
inches of the tape lengthwise, place unsplit
end on nose, wrap split ends around tube,
and secure to nose same maybe use taped
at the side of mouth.
18. Attach tube to suction, feeding, or
clamp as ordered.
19. Remove gloves and perform hand
washing.
20. Documentation
1. Insertion procedure with date and
time.
2. How tolerated by child.
3. Type and size of tube.
4. Which nostril used.
5. Patency.
6. Amount, color, and consistency of
returns.
7. Laboratory tests done on gastric
contents, if applicable.

Total Deduction of Demerit: ________

• Prescribed Hair (__)

• Prescribed Uniform (__)
• Completeness of paraphernalia/equipment/supplies (__)
Total score: _____________
I fully understand how I was graded for this skill and it was properly explained to me.

______________________________
Student’s FULLNAME & Signature
Date: ______________

I have explained and discussed how I have graded my student for this particular skill.

___________________________
Clinical Instructor FULLNAME & Signature
Date: _________