student-NG tube question

[sweetieann]

Hello all-

I was reading in my NCLEX review book about how you need an order to irrigate an NG tube. However, I always thought this was part of routine care to check patency. Which is correct?

Thanks so much!

[Julie_Bean]

you just use air to check patency

[purplemania, BSN, RN]

keep the questions coming! There are a million details to learn in nursing and even after you have been doing it for years you can always learn something else. Air is not water. Next time you may be the one who helps another newbie.

[sweetieann]

thanks!i understand that you can use air to check placement, but I am saying that don't you normally "flush the line" (irrigate) so that the tube doesn't get clogged? And isn't that just normal nursing practice...why would you need an order for that?

[Anagray, BSN]

Usually you would irrigate NGT every shift, but there are cases when you need an order to do so. We have a very complicated bariatric/thoracic patient who had so little stomach left that surgeons were afraid that too much irrigation can actually move NGT out of it's place and there were very specific orders in place regarding how to do it.

[Calgon-take.me.away]

Each NG and g and J tube MD order should have order written to clarify the amount before and after each med administration, and also the amount of flush q shift. Also, remember not to make a cocktail of g-gube meds. According to state, you must add each med separately, and give a 10 cc flush between each. And also, remember that when giving Dilantin, you need to hold the feeding 1 hour prior to and one hour after the Dilantin. This is especially true when the patient is receiving Jevity. Also, shake the liquid Dilantin bottle at least 2 minutes prior to pouring.

[spiceyqueen]

most places have an order that states how long the feeding hours, rate, amount to irrigate and how many hours in between. mostly its the dietician that sets out the feeding regime and all. well, that depends on your facility's protocols

[AlbertaBlue]

I completely agree with this posting. There are different occasions when you would not want to check the placement of an NG tube...as with esophagectomy patients whose stomachs have been anatomically shifted...you would never instill air in this case as the point of the NG is to decompress the stomach. In the case of surgical patients who require NG tubes we virtually never touch them unless the surgeons have clearly stated what they want us to do with them. Also, in the case of NG/J/or G-tubes that are being used for feeding...you would also hold the tube feed for two hours pre and post administration of Ciprofloxacin. And of course if you insert a Silastic NG you would never use it until it has been confirmed to be in place via CXR. Just some additional thoughts.

Usually you would irrigate NGT every shift, but there are cases when you need an order to do so. We have a very complicated bariatric/thoracic patient who had so little stomach left that surgeons were afraid that too much irrigation can actually move NGT out of it's place and there were very specific orders in place regarding how to do it.