TROUBLESHOOTING NASOGASTRIC TUBE

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COMPLICATION	NURSING INTERVENTION
Aspiration of gastric secretions	Discontinue feeding immediately. Perform tracheal suction of aspirated contents, if possible. Notify doctor. Prophylactic antibiotics and chest physiotherapy may be ordered. Check (NG) tube placement before feeding to prevent complications.
Tube obstruction	Flush the tube with warm water. Flush the tube with 50 ml of water after each feeding to remove excess sticky formula, which can clog the tube. When possible, use liquid forms of medications. Otherwise, crush well.
Oral, nasal or pharyngeal irritation or necrosis	Perform frequent oral hygiene using mouthwash or spongetipped swabs. Use petroleum or water based lubricant on cracked lips. Change the position of the tube.
Vomiting, bloating, diarrhea or cramps	Reduce the flow rate. If doing bolus, place the syringe lower to decrease the rate of the bolus. Warm the formula to prevent GI distress (run under warm water until lukewarm). NEVER MICROWAVE! For 30 minutes after feeding, position the patient on his right side with the head elevated to facilitate gastric emptying. Notify your doctor. He/she may want to reduce the amount of formula given.
Hyperglycemia	Monitor blood glucose levels. Notify doctor of elevated levels. Administer insulin, if ordered.
Constipation	Provide additional fluids if the patient can tolerate them. Administer a bulk-forming laxative (with doctor’s approval).