Nasoenteric-Decompression Tube Care
- Is inserted by a physician or nurse practitioner nasally and advanced beyond the stomach into the intestinal tract.
- The patient requires encouragement and support while the tube is in place.
- Care involves continuous monitoring to ensure tube patency, proper suction, and bowel decompression and to detect complications, such as skin breakdown and fluid electrolyte imbalances.
- Nasal polyps
- Deviated sputum
- Other obstruction that prevents insertions
- Suction apparatus
- Container of water
- Intake and output record sheet
- Mouthwash and water mixture
- Sponge tipped swabs
- Water soluble lubricants
- Cotton-tipped applicators
- Safety pin
- Tape or rubber band
- Disposable irrigation set
- Labels for tube lumens
- Throat comfort measures
Preparation of equipment
- Assemble the suction apparatus and set up the suction unit
- Test the unit to make sure that the suction works
- Verify the patient’s identity using two patient identifiers, such as the patient’s name and identification number.
- Reinforce the explanation of the procedure to the patient and family and answer questions.
- After tube insertion, have the patient lie on his right side for about 2 hours to promote the tube’s passage.
- After the tube advances past the pylorus, the physician or nurse practitioner can advance it 2” per hour.
- After it advances to the desired position, coil excess external tubing and secure it to the patient’s gown or bed linens; secure the tubes position by taping it to the patient’s face.
- Maintain slack in the tubing so the patient can move safely in bed.
- Remind the patient to call for assistance when getting out of bed.
- After securing to the tube, connect it to the tubing on the suction machine to begin decompression.
- Check the suction machine every 2 hours to confirm proper function.
- Empty the drainage container or mark the drainage level with the time and date every 8 hours. Record output.
- After decompression and before extubation, provide a clear-to-full liquid diet and monitor bowel function.
- Record intake and output to monitor fluid balance.
- Normal saline solution is preferred over water as an irrigant.
- Monitor the patient for signs and symptoms of pneumonia since he may be unable to clear his pharynx.
- Be alert for fever, chest pain, tachypnea, or labored breathing, and diminished breath sounds over the affected area.
- Observe the characteristics of the drainage.
- Provide mouth care frequently and encourage the patient to brush his teeth.
- Lubricate the patient’s lip with petroleum jelly.
- Monitor patient for peristalsis.
- For Miller-Abbot tube, clamp the lumen leading to the mercury balloon and label it “Do not touch”.
- Label the other lumen “suction.” Marking the tube may help prevent the accidental instillation of irrigant into the wrong lumen.
- Irrigate the tube with the irrigation set to clear the obstruction.
- If the tube connects to a portable suction unit, the patient may move short distances while the patient moves about.
- For throat irrigation, offer mouth wash, gargles or lozenges.
- Reinforce the explanation of the purpose of the procedure and advise the patient about what to expect during and after insertion
- Remind the patient of the signs and symptoms to report.
- Fluid and electrolyte imbalance, pneumonia, mercury poisoning, and intussusception of the bowel.