Removing a Nasogastric or Nasoenteric Tube

Removing a Nasogastric or Nasoenteric Tube

Equipment
■ Linen-saver pad.
■ 60-mL Luer-Lok or catheter-tip syringe.
■ Procedure gloves.
■ Stethoscope.
■ Disposable plastic bag.
■ Emesis basin.
■ Gauze square.

Assessment
■ To confirm readiness for discontinuing the NG or NE tube, auscultate the abdomen for the presence of bowel sounds and assess the patient’s ability to consume an oral diet.
■ Be Smart! Determine how long it has been since the last tube feeding, and wait at least 30 minutes to remove the feeding tube.

Post-Procedure Reassessment
■ Assess the nares for signs of skin breakdown or bleeding.
■ Monitor for signs of GI dysfunction, such as food intolerance, nausea, vomiting, and abdominal distention.
■ Monitor bowel sounds.
■ Monitor I&O every 8 hours.
■ Weigh the patient regularly.
■ Monitor laboratory values to evaluate nutritional status.

Key Points
■ Verify the primary provider’s order for removal of NG or NE tube.
■ Assist the patient to a sitting or high-Fowler’s position.
■ Place the linen-saver pad on the patient’s chest and don gloves.
■ If the NG tube is connected to suction, turn it off.
■ Stand on the patient’s right side if you are right-handed; on the left side if left-handed.
■ Inject 10 mL of air through the main lumen to clear the tube of secretions.
■ Unpin the tube from the gown and remove the tape from the nose.
■ Pinch the tube with one hand, hold gauze to the patient’s nose with the other hand, ready to grab the tube upon removal.
■ Ask the patient to hold his breath, and gently, but quickly, withdraw the tube and place it in the plastic bag.
■ Discard the equipment.
■ Provide or assist with care of the nose and mouth.

Documentation
■ Chart:
■ Date and time of removal.
■ Patient’s tolerance of the procedure.
■ The amount of drainage if the tube was connected to suction.
■ Note any complications following tube removal (e.g., food intolerance, nausea, vomiting, and abdominal distention).