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Wednesday, June 19, 2013

Nursing Review: Nasogastric Tube (NGT)

Nasogastric Tube (NGT)



Ø  Gavage (feeding) / Lavage (suctioning)
Ø  Select the nostril that has greater airflow.
Ø  Assist the client to a high fowler’s position
Ø  NEX technique (nose-ear-xiphoid)

Ø  Checking the patency:
ü  Aspirate stomach contents and check the pH, which should be acidic
ü  Introduce 10-30 ml of air into the NGT and auscultate at the epigastric area, gurgling sound is heard
ü  The most accurate method of assessing the placement of NGT is X-ray study

Ø  Before feeding assess residual feeding contents. To assess absorption of the last feeding, if 50 ml or more, verify if the feeding will be given.
Ø  Height of feeding is 12 inches above the point of insertion.
Ø  Ask the client to remain in position for at least 30 min

Ø  Common Problems of Tube Feedings
·         Vomiting
·         Aspiration
·         Diarrhea

·         Hyperglycemia
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Nursing Review: Urinary Catheterization

Urinary Catheterization



Ø  Use appropriate size of catheter
  • Male: Fr 16-18
  • Female: Fr 12-14

Ø  Place the client in appropriate position:
  • Male: Supine, legs abducted and extended
  • Female: Dorsal recumbent

Ø  Locate the urinary meatus properly:
  • Male: at the tip of the glans penis
  • Female: between the clitoris and vaginal orifice

Ø  Lubricate catheter with water soluble lubricant before insertion
  • Male: 6 – 7 inches
  • Female: 1 – 2 inches

Ø  Length of catheter insertion:
  • Male: 6 – 9 inches
  • Female: 3 -4 inches

Ø  Anchor catheter properly:
  • Male: laterally or upward over the lower abdomen / upper thigh
  • Female: inner aspect of the thigh


Nursing Interventions to Induce Voiding/Urination

Provide privacy
Assist the patient in the anatomical position of voiding
Serve clean, warm and dry bedpan (female) or urinal (male)
Allow the client to listen to the sound of running water
Dangle fingers in warm water
Pour warm water over the perineum
Promote relaxation
Provide adequate time for voiding

Last resort: URINARY CATHETERIZATION
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