What should the nurse do to verify nasogastric (NG) tube ...

[Melani1276]

What should the nurse do to verify nasogastric (NG) tube placement? (Select all that apply.)
 
  a. Ask the patient to speak.
  b. Inspect the posterior pharynx.
  c. Aspirate back on the syringe.
  d. Obtain an x-ray of the placement.
  e. Auscultate the lung fields.

Question 2

The Levin tube and the Salem sump tube are used most commonly for stomach decompression. Which of the following statements about these tubes is true? (Select all that apply.)
 
  a. Levin tubes have a blue pigtail that functions as an air vent.
  b. These tubes are inserted as a sterile procedure.
  c. The blue air vent should not be used for irrigation.
  d. The Salem sump tube has a blue pigtail that functions as an air vent.
  e. The Salem sump is preferred for stomach decompression.

[Joy Chen]

Answer to Question 1

A, B, C, D
While an x-ray examination is the gold standard to verify NG tube placement, there are several steps the nurse can take to gauge correct placement. Ask the patient to speak. If the patient is unable to speak, the NG tube may have passed through the vocal cords. Inspect the posterior pharynx for the presence of a coiled tube. The tube is pliable and will coil up behind the pharynx instead of advancing into the esophagus. Aspirate gently back on the syringe to obtain gastric contents, observing color. Gastric contents are usually cloudy and green but sometimes are off-white, tan, bloody, or brown. Aspiration of contents provides the means to measure fluid pH and thus determine tube tip placement in the GI tract.

Answer to Question 2

C, D, E
The Levin tube is a single-lumen tube with holes near the tip. You connect the tube to a drainage bag or to an intermittent suction device to drain stomach secretions. The Salem sump tube has two lumina: one for removal of gastric contents and one to provide an air vent, which prevents suctioning of gastric mucosa into eyelets at the distal tip of the tube. A blue pigtail is the air vent that connects with the second lumen. Never clamp off the air vent, connect it to suction, or use it for irrigation. NG tube insertion does not require sterile technique. Clean technique is adequate. The Salem sump is preferred for gastric decompression.