NG tube feeding/giving meds

Karou · Aug 30, 2014

After stopping the feeding, do you leave the end of the feeding still in the NG tube or remove it and cap it so you can give the medications? Also how fast or slow should the medications go in? After giving medications your would then flush with water and then attach the feeding back?
Does anyone have videos or pictures demonstrating the above?

You have to remove the end of the formula tubing from the NGT to be able to attach your syringe to the NGT. You can cap it but most often we just hang it at the top of the IV pole so it's out of the way. Make sure you paused it first. Keep the NGT pinched so you don't get gastric contents leaking back on you. Then attach your syringe and push the medication in.

There is no set rate on how fast or slow to push the medication. You don't want to slam them in but you can push gently. Sometimes you can give by gravity and not push at all (attach syringe without plunger while holding upright, pour water already mixed with meds in and it will infuse itself by gravity). It can be time consuming and medication can get stuck though. Honestly I've only ever done that with G tubes/PEG's, not NGT's. You flush with a small amount of water before meds, between meds, and at the end. Then attach feeding back.

Remember if you are infusing anything into an NGT you must have a chest x rat first verifying placement. Check yourself also with air injection before meds. Check residual before meds to be sure your patient is tolerating and digesting the formula at the infusion rate. Your facility will have a policy on how much residual is too much and what to do about it. Keep HOB elevated at all times.

I am sure you can google videos on it. G-tube/PEG tubes are the same idea. Hope I helped. If you get someone on your unit with one ask to watch another nurse administer medication, that will help you.

Mr. Murse · Aug 30, 2014

^ what they said.

Also, there are certain meds that recommend you stop the feed for a certain amount of time before and after administering the med (coumadin I think is one?), but it should say it on the MAR somewhere.

dexm · Aug 30, 2014

We attach a lopez valve that connects the end of the NGT/DHT/PEG tube/whatever to the formula tubing and allows you to administer meds through the port at the top. Most of my pts have continuous TFs, so I usually don't stop them when I'm giving meds (unless it's something like dilantin, synthroid, etc. that require the TFs to be off 1hr before/after administration). I just turn the valve so it's "off" to the TF tubing, instill the meds with a 60 cc syringe, and then turn it back "off" to the port thing at the top so the TFs can resume infusing.

RunnerRN2015, ASN, RN · Aug 30, 2014

^ what they said.
Also, there are certain meds that recommend you stop the feed for a certain amount of time before and after administering the med (coumadin I think is one?), but it should say it on the MAR somewhere.

I think Dilantin is one you have to stop feeds before administration.

GayPhil · Aug 30, 2014

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This journal article is quite useful, however probably only for those of us nurses in the UK (due to policies and procedures). We tend to measure the length of NG tubes and tape them in place, as well as draw aspirate from the tube to test the pH before administering meds. We don't always use X-ray for confirmation unless pH can't be confirmed or no aspirate can be taken.

nursearoo · Aug 30, 2014

Ph paper is the best way to check for proper placement...gastric Ph is below 5.5......also if the pt is on any meds like Pepcid, Zantac etc..anything like that it WILL affect the Ph so you should ask the MD what the acceptable Ph would be for verifying proper placement...years ago we used to do the air swish to check placement, however because it isn't really reliable, Ph is the best indicator for proper placement..... :-)

ixchel · Aug 30, 2014

When I've done meds via PEG, I've done it by gravity. Crush the meds and mix them in water (I do them individually so that if any don't go in and stay in for any reason, I know what went and what didn't). Have a cup of clean water available as well. Connect the giant syringe to the port, flush, and then remove the plunger. Pour each medication into the plunger as you hold it up, and you'll see the medications go in slowly and steadily. Be sure to pour in several ml of water to flush the tube between each medication and then flush at the end.

workinmomRN2012, BSN · Aug 31, 2014

Youtube usually has videos of all procedures, good iuck:yes:

OhioCCRN, MSN, NP · Aug 31, 2014

In my practice, we often use Corpaks (placed post-pyloric of course) and those are super easy to manipulate.

Sometimes when the anatomy of the patient makes a corpak unfeasible or they need TF for 1-2 days, they will have them infused through an NG tube, in that case, I simply add a corpak extension and its super easy giving meds!

psu_213, BSN, RN · Aug 31, 2014

Our hospital's policy (and the policy of everywhere I have worked as an RN) is that position must be confirmed by chest X-ray before giving a feeding through an NG. Air bolus is fine for confirming placement of an NG being used for suction, but there must be a chest x-ray before feedings.

Rnis, BSN, DNP, APRN, NP · Aug 31, 2014

Remember if it is to LIS you need to keep it clamped for 45 minutes