From the Guidelines
Nasogastric (NG) tube care orders should prioritize regular flushing, secure tube placement, and monitoring for complications to maintain tube function and prevent morbidity and mortality. The most recent and highest quality study 1 provides guidance on postprocedural considerations for NG tubes, emphasizing the importance of a multidisciplinary team approach for improved patient care. Key aspects of NG tube care include:
- Regular flushing with water to maintain patency and prevent clogging
- Securing the tube with hypoallergenic tape and rotating the tube position daily to prevent pressure injuries
- Cleaning the insertion site daily with mild soap and water to prevent skin irritation
- Monitoring for complications like displacement, obstruction, or infection by checking for abdominal distension, vomiting, or unusual drainage
- Documenting tube position, residual volumes, and patient tolerance For enteral feeding tubes, checking residual volumes every 4 hours during continuous feeds or before intermittent feeds and holding feeds if residuals exceed 200-250 ml is crucial 1. Additionally, considering the use of a nasal loop or bridling to secure the NG tube can reduce unintentional dislodgement and allow for greater caloric intake, as suggested by 1. However, the most recent study 1 takes precedence, and its recommendations should be prioritized in clinical practice.
From the Research
Orders for Nasogastric (NG) Tube Care
There are no specific orders for nasogastric (NG) tube care mentioned in the provided studies. However, the following general information about NG tube care can be found:
- The placement of a nasogastric enteral access device (NG-EAD) is a common practice, and correct initial placement and ongoing location verification are the primary challenges surrounding NG-EAD use 2.
- Routine gastrostomy tube care is important to maintain well-functioning tubes 3.
- Care practices for patients with enteral feeding tubes can vary widely, and an evidence-based clinical protocol for care of patients with enteral feeding tubes can improve staff knowledge and patient care 4.
Key Considerations
- Verification of NG tube placement is crucial to prevent complications, and methods such as abdominal radiograph can be used 2.
- Nursing knowledge and education on NG tube care and management are essential for providing high-quality patient care 4.
- Environment of care, including head of bed elevation and suction availability, is important for patients with NG tubes 4.