A nurse is assessing for correct placement of a client’s NG feeding tube prior to administering a bolus feeding.
Which of the following actions should the nurse take?
A.
Insert air in the tube and listen for gurgling sounds in the epigastric area
B.
Aspirate contents from the tube and verify the pH level
C.
Review the medical record for previous x-ray verification of placement
D.
Auscultate the lungs for adventitious breath sounds
The Correct answer and Explanation is:
The correct answer is B. Aspirate contents from the tube and verify the pH level.
Explanation:
When assessing the correct placement of a nasogastric (NG) feeding tube, the primary concern is to ensure that the tube is positioned in the stomach rather than the lungs or esophagus, as incorrect placement can lead to serious complications, including aspiration pneumonia.
Option A suggests inserting air into the tube and listening for gurgling sounds in the epigastric area. While this method, known as the “air bolus” method, was once commonly used, it is less reliable than other methods. It can produce false positive results, and the absence of sounds does not definitively indicate incorrect placement.
Option B is the most accurate and evidence-based method for verifying NG tube placement. By aspirating gastric contents and checking the pH level, the nurse can obtain a more definitive indication of whether the tube is correctly placed. Gastric contents typically have a pH of 1 to 4, while contents from the respiratory tract (like saliva or pulmonary secretions) will have a higher pH (around 6 or greater). If the pH level is consistent with gastric contents, this confirms the tube’s placement in the stomach.
Option C involves reviewing the medical record for previous x-ray verification. While this is important, it does not provide immediate verification for the current feeding. The tube may have shifted since the last x-ray.
Option D suggests auscultating the lungs for adventitious breath sounds. This is important for overall assessment of respiratory status but does not specifically confirm the placement of the NG tube.
In summary, aspirating gastric contents and verifying the pH level is a direct and reliable method for confirming that the NG tube is correctly placed in the stomach, making it the best choice among the options provided.