The nurse inserts a nasogastric (NG) tube to the measured length. Which method is the best way to confirm placement of the NG tube without an x-ray film?
a. Measure the pH of the gastric aspirate.
b. Ask the patient if the tube is comfortable.
c. Instill air and listen over the stomach.
d. Advance the tube past the measured length.
A
After inserting the NG tube to the measured length, the nurse asks the patient to speak, visualizes the tube in the posterior oropharynx, and analyzes the gastric aspirate for pH. If the tube is in the esophagus, the patient should be able to speak, the tube should be aligned with the esophagus, and the pH should be less than 4.0 . The NG tube is usually uncomfortable initially. The nurse avoids instilling air into the tube as a method of confirming placement because the tube can be in the lungs. Air injected into the stomach increases patient discomfort and gastric distention. The tube is advanced after initial placement assessments when confirmation indicates that it is not in the trachea but potentially has not reached the stomach.
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