A nurse is preparing to insert a nasogastric (NG) tube for a client who requires enteral tube feedings. To reduce the risk of respiratory complications and aspiration, arrange the following nursing actions in the correct chronological sequence.
- 1Place the client in a high Fowler's position.
- 2Measure the tube from the tip of the nose to the earlobe, and then down to the xiphoid process.
- 3Instruct the client to flex their head toward their chest and swallow as the tube is advanced.
- 4Secure the tube to the client's nose and aspirate gastric contents to test the pH.
- 5Obtain a chest radiograph to definitively confirm tube placement before initiating feedings.
Answer
The correct sequence is to first position the client upright, measure the correct length of the tube, safely advance the tube while the client swallows with their neck flexed, perform an initial bedside pH check, and finally verify placement with a radiograph before use.
Safe insertion of a nasogastric tube requires a systematic approach to prevent respiratory trauma and aspiration. The process begins with proper anatomical positioning (high Fowler's) and measuring the necessary length to reach the stomach. Advancing the tube with the neck flexed during swallowing protects the airway. Finally, while bedside methods like pH testing provide preliminary data, radiographic confirmation is mandatory before using the tube to eliminate the risk of administering feedings into the lungs.
Step-by-Step Solution
Key Concept
Nasogastric Tube Insertion Safety and Verification