NG Tube Question

[Alise]

Hello,

This is the first time I've actually used this site, so please bear with me. I am a new nursing student and on one of my assignments I was asked to explain why x-ray is the most definitive technique to evaluate the correct placement of a nasogastric tube. I can't explain it...I thought testing pH from the aspirated stomach contents was the most definitive way because the gastric contents are commonly pH 1 to 5, indicating that the tube is located where it should be in the stomach. If the pH is 6 or greater, it would indicate that the contents are from lower in the intestinal tract or in the respiratory tract. Obviously, I'm wrong. Can someone explain to me why

x-ray is the most definitive technique? Any help would be appreciated.

Thanks,

Alise

[W'sMama]

The NG tube has a thin radiopaque strip that shows up on the x-ray

[ImThatGuy, BSN, RN]

Because you can see....

[Alise]

Thanks very much. Alise

[chinacatSN]

We were told in class that gastric contents can vary from person to person, depending on certain medications they're taking and certain disease processes that are happening in their body.

X-ray is the best way to tell if the NG tube is in the correct spot because they can see for sure where it is in the body.

Hope this helps!

[Alise]

Thank you ChinaCatSN. As to the first paragraph of your response, would certain medications and disease processes affect the pH in stomach contents?

[CuriousMe]

Thank you ChinaCatSN. As to the first paragraph of your response, would certain medications and disease processes affect the pH in stomach contents?

A fast and obvious medication that will raise the pH of stomach contents are antacids.

[ckh23, BSN, RN]

I agree with the others because you can simply see it on xray. Same principle for getting a CXR after intubation instead of just relying on lung sounds, CO2 dector, etc.

Ph testing policy also depends on the facility. For example at my hospital we can not check a bedside ph for placement. I learned from the nurse educator that it is because of the lab. Apparently there is something that prevents us from doing it and if it needs to be done a sample has to be sent to the lab. When I worked in the ER we had a similar situation because they wouldn't let us do bedside pregnancy tests. We actually had to collect a urine sample and send it to the lab. Sometimes it's about the red tape.

[turnforthenurse, MSN, NP]

If the question asks what is the best way for the NURSE to verify placement, it is the pH of the aspirate. A lot of nurses will just push air into the tube and listen for a gurgle, but that is less accurate than to actually test the pH.

If it doesn't mention NURSE, then it is an x-ray, because nurses do not do x-rays.