Which is the most reliable method that indicates the end of a nasogastric tube is correctly placed?
a. Swallowing, coughing, and gagging reflex are intact.
b. The pH of aspirated fluid is 5 or lower.
c. The fluid has a grassy green appearance.
d. Insufflation of air is auscultated over the epigastrium.
B
The pH of fluid aspirated from the stomach should be 5 or lower. This is the most reliable method for indicating that a nasogastric tube is properly placed. Intact swallowing, coughing, and gagging reflexes should not be used in the determination of nasogastric tube placement. Fluid aspirated from the stomach can have a grassy green, brown, or clear, mucoid-flecked appearance, but this is not the most reliable way to determine correct placement. A whooshing or gurgling sound can be heard as air injected into the tube enters the stomach, but this is not the most reliable method for determining tube placement.
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