NG out-what to do?

[montinurse, BSN]

So I'm taking care of a pt whose had an NG down to low int. suction for a few days d/t possible bowel obstruction. This day I'm taking care of her, she finally has a normal, brown, loose, hemoccult negative stool, cdiff negative, no N/V for 2 days, voiding, ambulating, afebrile. Had auscultated and noted gastric contents a few hours prior to all this..

The aid comes to get me after AM care, saying it does "sound right". I walked in the room to the pt gagging/choking, sitting up in the chair. I could hear the suction in her throat. I have worked in the hospital for about 6 months now. My first reaction was to pull the tape off her nose and tube out of her throat. Not even 3 inches of tubing was left..Was that right? I work on a busy floor, and am initimidated by some of the nurses. I know I question them to death sometimes....I hate always asking, "did I do this right"? or "what would you do?" Was that the right thing to do? The doc was there, so he was aware. He didn't order it to be put back down and new abd xrays since she was doing so well....

[montinurse, BSN]

Anyone? My med/surg book from college doesn't even address this..

[Super Nurse JoshuA]

This sounds appropriate to me. You would not had wanted the patient to continue gagging while you went to check to attempt to place it back down. You had reasonable expectation that the NG Tube was going to be discontinued due to the patient having a formed bowel movement post bowel obrsturction. Good job, IMO.

Joshua

[azrn08]

I say you were right...CYA in your nurses note state something like @ such time pt found in distress coughing/chocking NG tube was likely the source therefore I pulled the NG tube to find only approx. 3 inches still in place. After NG pulled pt found to be a great deal more comfortable. Dr notified and no new orders received.

[diane227, LPN, RN]

You did the right thing. Pull it out. Sounds like the patient did not need it any more anyway. Ask the doc if he wants it replaced.

[AuntieRN]

I would have done the same thing. And please dont feel like you are asking too many questions. I can tell you as a charge nurse I would rather you ask me a million and one questions then to not ask, do something and harm the pt. Everyone asks questions. Its how you learn especially when you are fairly new. I work with nurses who have been at it 20+ years and they still ask questions.

[Zaynab]

You did fine. When an NG tube is displaced you may not be able to tell how far it was in originally. I find that when in doubt, start over and put down a new one at the correct length and recheck that you get air bubbles in the belly. It was better to pull out a displaced tube that could gag the patient and cause them to vomit and aspirate versus leave a useless item in place.

[montinurse, BSN]

Thanks all!