Nasogastric Tube Feeding

Definition:
A feeding tube is a medical device used to provide nutrition to patients who cannot obtain
nutrition by swallowing. The state of being fed by a feeding tube is called enteral feeding or
tube feeding. Placement may be temporary for the treatment of acute conditions or lifelong in
the case of chronic disabilities. A variety of feeding tubes are used in medical practice. They are
usually made of polyurethane or silicone. The diameter of a feeding tube is measured in French
units (each French unit equals 0.33 millimeters). They are classified by site of insertion and
intended use.
Purpose:
• To restore or maintain nutritional status
• To administer medication

Materials:
• Correct amount of feeding solution
• 20 to 50 ml syringe with an adapter
• Emesis basin
• Clean gloves
• Large syringe with plunger or calibrated plastic feeding bag with tubing that can be
attached to the feeding tube or prefilled bottle with a drip chamber, tubing, and a flow-
regulator clamp
• pH test strip or meter
• Measuring container from which to pour the feeding ( if using open system)
• Water ( 60 ml unless otherwise specified) at room temperature
• Feeding pump as required

Procedure Rationale Responsible Person

1. Assist the client to a These positions enhance the Registered Nurse

Fowler’s position in bed or gravitational flow of the
sitting position in a chair, solution and prevent aspiration
the normal position for of fluid into the lungs.
eating. If a sitting position
is contraindicated, a
slightly elevated right side
lying position is
acceptable.
2. Explain to the client what
you are going to do, why it
is necessary, and how he r
she can cooperate. Inform
the client that the feeding
should not cause any
 discomfort but may cause
feeling of fullness. For an
adult, the usual
intermittent feeding will
take about 30 min. the
exact length of time
depends largely on the
volume of the feeding.
3. wash hands and observe
appropriate infection
control procedure
4. Provide privacy for this
procedure if the client
desires it.
5. assess tube placement.
a. attach the syringe
to the open end of
the tube and
aspirate alimentary
secretion. Check
pH.
b. Allow one hour to
elapse before
testing the pH if
the client has
received a
medication
c. Use pH meter
rather than pH
paper if the client
is receiving a
continuous feeding
or if food coloring
has been added to
formula.
6. Assess residual feeding
contents.
a. aspirate all This is done to evaluate
stomach contents absorption of the last feeding;
and measure the that is, whether undigested
amount before formula form the previous
administering the feeding remains.
feeding
b. if 100 ml (or more
than half the last
feeding) is
 withdrawn, check
with the nurse in
charge or refer to
agency policy
before proceeding
the precise amount
is usually
determined by the
physician’s order
or by agency
policy.
7. Administer the feeding.
• before administering the
feeding:
Check the expiration date
of the feeding
Warm the feeding to An excessively cold feeding
room temperature may cause cramps
• when an open system is This minimizes the risk of
used, clean the top of the feeding contaminants entering the
container with alcohol before feeding syringe or feeding bag
opening it

FEEDING BAG (OPEN

SYSTEM)
•hang the bag from an infusion
pole about 30 cm. (12 in.) above
the tube’s point of insertion into
the client.
•clamp the tubing and add the
formula bag
•open the clamp, run the formula
through the tubing, and reclamp
the tube. The formula will
displace the air in the tubing,
thus preventing the installation
of excess air into the client’s
stomach or intestine.
•attach the bag to the
nasogastric/nasoenteric tube and
regulate the drip by adjusting the
clamp to the drop factor on the
bag.
SYRINGE (OPEN SYTEM)
•remove the plunger from the Pinching or clamping the tube
syringe and connect the syringe prevents excess air from
to a pinched or clamped entering the stomach and
nasogastric tube. causing distention.
•add the feeding to the syringe
barrel.
•insert the feeding to flow in
slowly at the prescribed rate.
Raise or lower the syringe to
adjust the flow as needed. Pinch Quickly administering
or clamp the tubing to stop the feeding can cause flatus,
flow for a minute if the clients cramps, and/or reflux
feel discomfort. vomiting.
PREFILLED BOTTLE WITH
DRIP CHAMBER(CLOSED
SYSTEM)
•remove the screw on cap from
the container and attach the
administration set with the drip
chamber and tubing
•close the clamp on the tubing
•hang the container on an At this height, the formula
intravenous pole about 30 cm should run at a safe rate into
(12 in) above the tube insertion the stomach or intestine.
point into the client.
•squeeze the drip chamber to fill
it to one half of its capacity
•open the tubing clamp, run the
formula through the tubing, and
reclamp the tube
•attach the feeding set tubing to
the feeding tube and regulate the
drip rate to deliver the feeding
over the desired length of time.
Prefilled tube feeding sets can be
attached to a feeding pump to
regulate the flow.
8. Rinse the feeding tube
immediately before all of
the formula has run
through the tubing
• instill 50 to 100 ml of water
through the feeding tube. Water
flushes the lumen of the tub,
preventing future blockage by
sticky formula.
• be sure to add the water
before the feeding solution has
drained from the neck of a
syringe or from the tubing of an
administration set. Before adding Adding water before the
water to a feeding bag or syringe or tubing is empty
prefilled tubing set, first clamp prevents the instillation of air
and disconnect both feeding and into the stomach or intestine
administration tubes. and thus prevents unnecessary
distention.
9. Clamp and cover the
feeding.
•clamp the feeding tube before To prevent leakage
all of the wter instilled
•cover the end of the feeding
tube with gauze held by an
elastic band
10. Ensure client comfort and
safety
11. Dispose the equipment
appropriately
12. Document all relevant
information
13. Monitor client for possible
problems