c. Place a towel or Chux pad around the patient's neck as a "bib".
d. Place the tissues and the glass of water convenient to the patient's hand. Tell
him that small sips of water will help him to swallow during the procedure and that he
can expect tears and flow of nasal secretions.
CAUTION: Do not emphasize the possibility of gagging or vomiting, but place the
emesis basin convenient to your hand.
e. Measure the correct length of tubing to be inserted by following the steps
below. (This is done to ensure passage of the tube into the stomach.)
Use the tube to measure from the patient's ear lobe to the tip of his
(2) The distance from the tip of the nose to the bottom of the xiphoid
process (tip of breastbone). Mark this distance with a piece of adhesive tape.
f. Lubricate the tip of the tube with water-soluble lubricant to prevent injury to
the nasal mucosa.
g. Insert the tube.
(1) Instruct the patient to tilt his head back and insert the tube into one of
the nares. Advance slowly.
(2) When you feel the tube begin to curve down in to the pharynx, instruct
the patient to tilt his head forward slightly. This position facilitates passage of the tube
by closing the trachea and opening the esophagus for ease of swallowing.
(3) Unless contraindicated, instruct the patient to swallow sips of water.
Continue to advance the tube to the desired distance as the patient swallows.
Advance the tube the measured distance.
CAUTION: Discontinue insertion immediately if the patient coughs or chokes.
Remove the tube completely. Allow the patient to rest for a few minutes
before attempting reinsertion. Discontinue the procedure again if
coughing, choking, or excessive gagging occurs. Report two
unsuccessful attempts to the professional nurse.
h. Test for placement of tube in stomach. (Tube may be lightly taped to avoid
movement during placement testing.)