In caring for a critically ill client with a nasogastric tube (NGT) for enteral feeding, which action by the nurse demonstrates competency in NGT care? Select all that apply.
The nurse checks gastric residual every 4 hours for continuous feedings.
The nurse maintains the client in a low Fowler’s position during feeding.
The nurse checks gastric residual before each bolus or intermittent feeding.
The tubing is changed every 48 hours or when the bag appears visibly soiled.
The nurse returns the residual to the stomach unless the volume is greater than 250 mL.
Numbers 1, 3, and 5 are correct.
With continuous feedings, residual should be checked every 4 hours to assess for delayed gastric emptying. In noncritical clients, residual should be checked every 4 to 6 hours or according to agency policy. Residual is also checked before each bolus or intermittent feeding. If the volume is less than 250 mL, the contents are returned to the stomach to prevent electrolyte imbalance. For volumes greater than 250 mL, the nurse should follow agency policy or prescriber’s orders. Clients should be positioned in a high Fowler’s position or with the head of bed elevated at least 30 (preferably 45) degrees to prevent aspiration. The tubing and bag are changed every 24 hours to prevent bacterial growth.
