How to Assess Placement of a Nasogastric Feeding tube

When a patient has difficulty swallowing, he may not get the adequate nutrition that he needs. Therefore, its important for his health care provider to provide another route for feeding. A nasogastric tube is one option used to provide nutrition to hospitalized patients. Nurses may give nutrition and medication through this tube but before they do this, they must make sure the tube is in the patients stomach.

Instructions

1. Listen for air exchange. As the naso gastric tube is advanced into the patient, when it gets to the carina stop and place the end of the tube close to your ear. If you hear air, the tube may be in the patients air ways. Stop and remove it. This method should NOT be used to VERIFY final placement of the tube.

2. Aspirate stomach contents. Once the tube gets to the stomach, insert a syringe into the end of the tube and aspirate fluid from the patients stomach. Test this fluid with litmus paper. Then read the ph results. It should be below 4 showing the stomach contents are acidic and that the tube is in the stomach.

3. Order a chest x ray. The definitive way to assess for placement of a naso gastric feeding tube is by doing a chest x ray on the patient. The nurse should consult the physician for an xray order.

Tips & Warnings

• Listening for air should not be used to verify final placement of the tube.

Resources

• Online Review courses for Student nurses