Nasogastric and Gastrointestinal Intubations

A client’s condition may warrant special interventions to decompress the gastrointestinal tract. GI intubation is one of these interventions. Paralytic ileus is one of the conditions that would warrant intubation

Paralytic Ileus

Etiology- Cessation of peristalsis resulting from:– Neurogenic impairment– Mechanical obstruction– Direct irritation

Pathophysiology- When peristalsis ceases, the stomach or small intestine (depending on location of problem or impairment) becomes distended from large quantities of air and fluid

Signs and Symptoms- Abdominal distention, cessation of BMs, absent bowel sounds, vomiting

Purpose and Types of Tubes

Nasogastric Tubes- Primarily inserted fo decompression of the stomach

Types of tubes– Levin– Salem Sump– Dobhoff or Duo

Purpose and Types of Tubes

Intestinal Tubes- Long intestinal tubes serve several purposes:– Decompression– Splinting– Determination of obstruction site

Types of tubes– Miller-Abbott– Cantor

Measuring and Inserting an NG tube

Facilitating Tube Drainage

Because gastric and intestinal fluid must move against gravity to be removed suction is required– Low Suction– High Suction– Intermittent Suction– Constant Suction

Proper functioning

Prevention of Injury

Anchoring the tube Pin tube

Prevention of Injury

Prevent Oral Inflammations– Keep oral membranes moist– Use of ice chips– Hard candy

Prevent reflux and/or aspiration

Promotion of Comfort

Removal of excess secretions Water soluble lubricant Relief for sore throat

– Warm saline gargles– Ice bag to neck– Prescribed throat lozenges– Position changes

Specialty Tube

Sengstaken- Blakemore Tube– Used to control esophageal varices

– Multi-lumen tube with 2 balloons