VELEZ COLLEGE

COLLEGE OF NURSING
F. Ramos St. Cebu City

NURSING CARE MANAGEMENT 109:

NGT/OGT Feeding

Procedure Study
Procedure & Materials Indications Contraindications & or Steps Nursing Considerations
Complications
1. NGT/OGT - Gastric Contraindications: Prior Tube Feeding: ● When beginning
Feeding decompression, - Severe midface 1. Wash your hands, enteral feedings,
- NGT/OGT including trauma introduce yourself monitor the patient
(Enteral) feeding maintenance of a - Recent nasal surgery to the patient and for feeding
refers to the decompressed Relative: clarify their identity. tolerance. Assess the
intake of food via state after - Coagulation Explain the abdomen by
the GI tract. endotracheal abnormality procedure to the auscultating for
Nasogastric tube intubation - Esophageal varices or patient and gain bowel sounds and
(NGT) starts in - Relief of symptoms stricture their consent to palpating for rigidity,
the nose and and bowel rest in proceed. distention, and
ends in the the setting of 2. Estimate the length tenderness.
stomach while of the tube to be
 Orogastric tube small-bowel - Recent banding or inserted. Do this by ● Assess for allergies
(OGT) starts in obstruction cautery of esophageal measuring the NG to any food in the
the mouth and - Aspiration of gastric varices tube from the tip of feeding. If the client
ends in the content from - Alkaline ingestion the nose, to the tip is lactose intolerant,
stomach. recent ingestion of of the nose, to the check the feeding
toxic material Complications: earlobe and then to formula.
Materials: - Administration of - Aspiration and tissue the xiphisternum ● Know that patients
● Correct type medication - Placement of the 3. Apply a small who complain of
and amount of - Feeding catheter can induce amount of lubricant fullness or nausea
feeding - Bowel irrigation gagging or vomiting to the tube after a feeding starts
solution - Head and neck - Patient discomfort 4. Give patient glass of may have a higher
● Gloves injury - Epistaxis water GRV.
● Fine bore - Coma - Pulmonary 5. Get the patient to ● On an ongoing basis,
nasogastric - Severe anorexia complication sniff. The nostril monitor patients for
tube or nervosa - Esophageal with better airflow gastric distention,
nasogastric - Recurrent episodes perforation is usually the easier nausea, bloating,
“Ryles’ tube of aspiration side. and vomiting.
16Fr - Poor oral intake 6. Your patient will ● Stop the infusion
● Water resistant usually be awake and notify the
lubricant during this provider if the
● Syringe procedure, ensure patient experiences
● Bile bag they are not acute abdominal
● Securing device experiencing too pain, abdominal
or tape much discomfort rigidity, or vomiting.
● Cup of water
● pH indicate 7. Pass the tube FOR PEDIATRIC CLIENTS:
paper horizontally along ● Feeding tubes may
● Anaesthetic the floor of the be removed after
throat spray nasal cavity. Passing each feeding and
it upwards will hit reinserted at the
the turbinates next feeding to
which will cause prevent irritation of
pain the mucous
8. Ask the patient to membrane, nasal
indicate when the airway obstruction,
tube is at the back and stomach
of the throat, or if perforation that may
they have had occur if the tube is
anaesthetic spray left in place
ask the patient to continuously.
open their mouth ● Formula should not
and look for the end be allowed to hang
of the tube. more than 4 hours.
9. Once the tube has ● Position a small child
advanced to the or infant in your lap,
back, ask the provide a pacifier,
patient to hold and hold and cuddle
some water in their the child during
mouth feedings. This
promotes comfort,
10. As they swallow, supports the normal
advance the tube sucking instinct of
slowly, but firmly. It the infant, and
should slide easily. If facilitates digestion.
you encounter
resistance, it may be
that the tube has
curled up in the
back of the mouth
11. Sequential
swallows of sips of
water
R: To allow gradual
progress of the tube
12. Aspirate from the
tube using a syringe.
Test the aspirate
using pH indicator
paper. The pH
should be 1-5.5
13. If satisfied that the
pH is correct, and
the tube is draining
gastric fluid, secure
the tube with tape
 and attach a bile
bag

Administering a Tube
Feeding:
14. Assist the client to a
Fowler’s position in
bed or sitting in a
chair, the normal
position for eating.
R: To enhance the
gravitational flow
of the solution and
prevent aspiration
of fluid into the
lungs.
15. Before
administering
feeding:
a. Check the
expiration date
of the feeding.
 b. Warm the
feeding to room
temp.
R: An excessively
cold feeding
may cause
abdominal
cramps.
Feeding Bag (Open
System)
i. Apply a label that
indicates the date,
time of starting the
feeding, and
nurse’s initials on
the feeding bag.
Hang the labeled
bag from an
infusion pole about
30cm (12in.) above
the tube’s point of
insertion into the
client.
R: At this height,
the formula should
 run at a safe rate
into the stomach
or intestine.
ii. Clamp the tubing
and add the
formula to the bag.
iii. Open the clamp,
run the formula
through the tubing,
and reclamp the
tube.
R: The formula will
displace the air in
the tubing, thus
preventing the
installation of
excess air into the
client’s stomach or
intestine.
iv. Attach the bag to
the feeding tube
and regulate the
drip by adjusting
the clamp the drop
factor on the bag if
 not placed on a
pump.
Syringe (Open System)
i. Remove the
plunger from the
syringe and
connect the
syringe to a
pinched or
clamped
nasogastric tube.
R: Pinching or
clamping the tube
prevents excess
air from entering
the stomach and
causing
distension.
ii. Add the feeding to
the syringe barrel
iii. Permit the feeding
to flow in slowly at
the prescribed
rate. Raise or
lower the syringe
 to adjust the flow
as needed. Pinch
or clamp the
tubing to stop the
flow for a minute
if the client
experiences
discomfort.
R: Quickly
administered
feedings can
cause flatus,
cramps, and/or
vomiting.
Prefilled Bottle with
Drip Chamber (Closed
System)
i. Remove the
screw-on cap from
the container and
attach the
administration set
with tubing.
ii. Close the clamp
on the tubing.
iii. Hang the
container on an
intravenous pole
about 30cm
(12in.) above the
tube’s insertion
point into the
client.
R: At this height,
the formula
should run at a
safe rate into the
stomach or
intestine.
iv. Squeeze the drip
chamber to fill it
to one third to one
half of its capacity.
v. Open the tubing
clamp, run the
formula through
the tubing, and
reclamp the tube.
R: The formula
will displace the
 air in the tubing,
thus preventing
the installation of
excess air.
vi. Attach the feeding
set tubing to the
feeding tube and
regulate the drip
rate to deliver the
feeding over the
desired length of
time to attach to a
feeding pump.
15. If another bottle is
not to be
immediately hung,
flush the feeding
tube before all the
formula has run
through the feeding
tube or medication
port.
● Instill 50-100ml
of water through
the feeding tube
 or medication
port.
R: Water flushes
the lumen of the
tube, preventing
future blockage
by sticky formula.
● Be sure to add
water before the
feeding solution
has drained from
the neck of a
syringe or from
the tubing of an
administration
set.
R: To prevent the
installation of air
into the
stomach/intestin
e thus prevents
unnecessary
distention.
16. Clamp the feeding
tube before all the
water is instilled.
R: Clamping
prevents air from
entering the tube.
17. Secure the tubing to
the client’s gown.
R: To minimize
pulling of the tube
thus preventing
discomfort and
dislodgement.
18. Ask the client to
remain sitting
upright in Fowler’s
position.
R: To facilitate
digestion and
movement.
After Tube Feeding:
19. Dispose of
equipment
appropriately.
 29. Document relevant
information.
39. Monitor client for
possible problems.

Group Four: NGT/OGT Feeding