Definitio

n
It is the insertion of a tube into the oesophagus
and stomach through the nose
It is defined as the passage of single or double
lumen tube through the nose or mouth to stomach for
the purpose of the drainage, instillation,
decompression, lavage or performance of diagnostic
tests.
 Purpos
e
• To feed the patient with fluids when oral intake is
not possible
• To dilute and remove consumed poison
• To instill ice cold solution to control gastric
bleeding
• To prevent stress on operated site by
decompressing
• To relive vomiting and distension
• To collect gastric juice for diagnostic puposes
 Indication
s
• Patient who cannot eat (GIT functioning
normally)
– Comatose patient
– Mechanically ventilated
• Patient who will not eat
– Patients who refuse to eat
• Elderly
• Disoriented patients
– Patients who cannot maintain adequate oral nutrition
• Patients with infection, trauma, cancer etc.
– Surgery
 Contraindications
• Gastric surgery
• Ulcers
• Tracheoesophageal fistula
• Oesophageal surgery
• Polyps in nose , recent nasal surgery, facial
surgery
• Deviated nasal septum
• Patient on anticoagulant therapy
General
instructions
• Remove the dentures ( to prevent it from dislodging and
blocking the respiratory tract)
• A rubber tube may be placed in a bowl of ice to cool and stiffen
• Lubricate the tube
• While removing the tube, pinch the tube and pull it
out gently and quickly (so that the fluid may not trickle
down the pharynx )
• During introduction of the tube never use force (it may cause
injury to mucus membrane)
• Watch the complications (nausea, vomiting, distension,
diarrhea, aspiration, pneumonia etc.)
 Ryle’s
tube
• Flexible rubber or synthetic material
• Transperant or opaque
• Length : 36-50 inches
• Gastrostomy tube: 12-15 inches
• The lumen is measured by French (Fr)
• When no is lower the inside diameter of
tube will be smaller
 Ryle’s
tube
• Parts
– Tip
•D
r
a
i
n
a
g
e

p
o
Polyurethane NG tube (Viasys Corflo), 8 Fr × 36 in (91 cm).
 Preliminary
assessment
Check
– Doctors order for any specific
instruction
– Patient ability to follow instructions
– General condition of the patient
– Articles available in the unit
 Preparation of patient and
•
unit
Explain the sequence of procedure
• Arrange the articles at the bed side
• Provide privacy
• Provide comfortable position (fowler’s position ,
comatose patient semi-fowlers position)
• Place the mackintosh and towel across the chest
• Remove the dentures
• Give mouth wash and help him to clean the teeth
• Clean nostrils
Procedur
e
POSITIONING
Method to confirm NG tube in the
stomach
• Aspirate: attach the syringe to the end of NG tube
and aspirate small amount of gastric content
• Immerse distal end of tube into bowl of water and
check for air bubbles
• Auscultate : attach syringe to free end of the tube,
place diaphragm of stethescope over left hypochondrium
.inject 10 ml of air and auscultate abdomen for
gushing sound.
• X ray
 After
care
• Offer a mouth wash . Clean the face and hands and
dry them
• Remove the mackintosh and towel
• Make the patient comfortable in bed
• Take all articles to the utility room discard the
waste, clean it and replace it in a proper place
• Wash hands
• Record the procedure
NG TUBE FEEDING
(GASTRIC
GAVAGE)
Definitio
n
Nasogastric tube feeding is given through tube
which is inserted through patient’s nose into
stomach when patient is unable to take food orally
It is a process of giving liquid nutrients or
medications through a tube into the stomach when the
oral intake is inadequate or impossible
Gastric
gavage
it is an artificial method of giving fluids &
nutrients through a tube, that has passed into the
oesophagus and stomach through the nose, mouth or
through the opening made on the abdominal wall,
when oral intake is inadequate or impossible
 Indication
s
• Unconscious
• Client with psychosis
• Swallowing
difficulties
• Chronic infections
• Anorexia nervosa
 Advantage
s
• An adequate amount of all types of nutrients
including distasteful foods & medications can be
supplied
• Large amount of fluids can given with safety
• It can be continued weeks with out any danger
• The stomach may be aspirated at any time of
desired
• Overloading of the stomach can be prevented by
drip method
 Principle
s
• A thorough knowledge of the anatomy and physiology
of digestive tract and respiratory tract, ensures safe
induction of the tube
• Microorganisms enter the body through food and
drink
• Mental and physical preparation of the patient
facilitate introduction of the tube
• Systematic ways of working adds to the comfort and
safety of the client and help in the economy of
material, time and energy
 Preliminary
assessment
• Identify the correct patient
• Check the doctor’s order
• Check the level of consciousness
• Check whether feed is ready at
hand
• Articles available in the unit
 Preparation of patient and
environment
• Explain the sequence of procedure
• Provide adequate privacy
• Position (sitting or semi fowlers)
• Place mackintosh and towel around the
neck
• Arrange the articles at the bed side
locker
• Clean the mouth by providing
mouthwash
 Article
s
• A tray containing
– Mackintosh and towel
– 50cc syringe/ feeding tube and 5cc
syringe
– Stethoscope
– Bowel with water
– Adhesive with scissors
– Feeds and water
– Ounce glass
– Kidney tray
 Procedur
 Wash hands
e
 Place towel around the neck
 Ensure the tube is in the stomach
 Remove plunger from syringe…………..Pinch tube to prevent
air entry……….Remove spigot….connect syringe to the tube.
 Keep syringe about 12 inches above patients head.
 Start feed with small measured amount of water and allow feed to
follow slowly and steadily through tube in such a way, that air does
not enter tube
 Do not force fluid, allow to flow by gravity
 At end of feed flush tube by pouring small measured amount of
water
…..remove syringe and replace spigot
 After
care
• Remove towel
• Place the patient in comfortable position
• Replace the articles to utility room, clean it and
replace it
• Record the procedure in nurses record and
intake out put chart.
Gastrostomy
feeding
Jejunostomy
feeding
 Gastrostomy feeding :feeding is given through
an artificial opening made surgically into the stomach
through the abdominal wall for feeding purpose
when the patient is not able to swallow through
oesophagus.
Jejunostomy
feedingJejunostomy
: is the surgical creation of an
opening (stoma) through the skin at the front of the
abdomen and the wall of the jejunum(part of the
small intestine)

• A jejunostomy is an alternative to a gastrostomy .

WRITE ASSIGNMENT ON RYLES’ TUBE

SUBMIT BY : 12/04/2021 (PDF)