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Nasogastric Tube Insertion and Care

Nasogastric (NG) tubes are used for feeding or decompression. Nurses must confirm correct placement before use and prevent aspiration.

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Key Points to Know

What you must know about Nasogastric Tube Care

1

Measure NG tube length from the nose to the earlobe to the xiphisternum (NEX measurement).

2

Confirm placement before feeding — aspirate gastric contents and test pH (acidic, ~1–5.5).

3

Sit the patient upright (Fowler’s position) during insertion and feeding.

4

Ask the patient to swallow (or sip water) as the tube is advanced to ease passage.

5

Keep the head of the bed elevated during and after feeding to prevent aspiration.

6

Check placement, flush the tube, and monitor tolerance with each feed.

NMCN Exam Tips

How this topic appears in the NMCN exam

Confirming correct placement BEFORE feeding is the priority safety step.

Gastric aspirate pH testing is a reliable bedside placement check.

Upright positioning prevents aspiration during feeding.

Remember NEX measurement (Nose–Earlobe–Xiphisternum).

Practice Question

Test yourself

Before administering a feed through a newly inserted nasogastric tube, the nurse must FIRST:

A.Flush the tube with 60 mL of milk
B.Confirm correct placement of the tube in the stomach✓ Correct
C.Lay the patient flat
D.Warm the feed in a microwave

Explanation

Confirming correct placement (e.g., by aspirating gastric contents and testing pH) is essential before any feed to avoid instilling fluid into the lungs, which could be fatal. The patient should also be upright.

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