For faculty use only Date Educator’s name Score

ATI Skills Modules Checklist for Nasogastric Intubation

Student’s name Date

Check/ Item Comments initial Verify order Patient record Assess for procedure need

Identify, gather, Inserting a nasogastric tube and prepare (suction apparatus, clean gloves, penlight, equipment and stethoscope, bath towel, anesthetic gel, supplies cotton-tipped applicator, cup of water, straw, empty cup for aspirate, pH reagent strip, emesis basin, facial tissues, tongue blade, permanent marker, scissors, tape, attachment device for gown, skin adhesive, water-soluble lubricant, 60-mL syringe, tube fixation/anchoring device for nose, nasogastric tube) Gastric decompression (suction apparatus, suction tubing, clean gloves, stethoscope, 60-mL syringe, towel or disposable pad, adapter for connecting suction tubing to nasogastric tube) Care and maintenance of a nasogastric tube (clean gloves, basin of warm water, washcloth, towel, irrigant solution, 60-mL syringe, empty cup for aspirate, pH reagent strips, penlight, water-based lubricant, toothbrush, toothpaste, emesis basin, cup of water, straw) Removing a nasogastric tube (suction apparatus, clean gloves, towel or disposable pad, facial tissues)

Apply principles of Hand hygiene aseptic practice Personal protective equipment Disposal of waste

ATITESTING.COM 800.667.7531 Check/ Item Comments initial Communicate Privacy effectively Patient identification Patient teaching

Provide for a safe Body mechanics environment Equipment placement Patient safety

ATITESTING.COM 800.667.7531 ATITESTING.COM 800.667.7531 Demonstrate procedural steps Check/ Item Task Comments initial Inserting a Have suction available. nasogastric tube Place patient in high Fowler’s position. Assess nasal passages with penlight. Assess gag response by gently placing the tongue blade against uvula. Explain how patient can communicate during procedure. Measure tube for length of insertion and mark length with tape or permanent marker. Cover patient’s chest with towel. Have patient hold emesis basin and cup of water. Coat tip of tube with water-based lubricant. Slowly insert tube into naris. Instruct patient to touch chin to chest. Advance tube each time patient swallows until reaching marked spot. For resistance, significant coughing, gagging, choking, or changes in vital signs, pull back on tube until resolved. Use penlight to look at back of throat. Auscultate for breath sounds. Using syringe, withdraw gastric contents, assess aspirate, and test pH. Anchor tube to nose. Mark tube directly below naris. Fasten tube to gown. Keep head of bed above 30 degrees.

Gastric Check nasogastric tube placement. decompression Auscultate air instillation over stomach. Place towel under tubing. Verify that suction is working and set on prescribed amount. Connect nasogastric tube to suction tube via adapter.

ATITESTING.COM 800.667.7531 ATITESTING.COM 800.667.7531 Demonstrate procedural steps Check/ Item Task Comments initial Care and Monitor gastric drainage and gastrointestinal maintenance of a function. nasogastric tube Follow facility policy for verifying correct tube placement and irrigation. Assess tube placement by looking the mark below the naris. Using syringe, withdraw gastric contents, assess aspirate, and test pH. Draw irrigation solution into syringe and slowly instill into tube. Reconnect nasogastric tube to suction. With a sump tube, instill 10 to 20 mL of air into the vent lumen. Regularly check tape or securement device. Inspect naris and surrounding skin. Clean area around tube at least every 8 hr. Apply water-based lubricant to naris as needed. Provide oral care frequently.

Removing a Place towel over patient’s chest. nasogastric tube Provide patient with facial tissues. Position patient upright. Have suction apparatus available. Remove tape from nose and detach securement device. Instruct patient to hold breath. Gently and steadily withdraw tube, controlling its tip. Inspect tube.

ATITESTING.COM 800.667.7531 ATITESTING.COM 800.667.7531 Documentation Check/ Item Task Comments initial Document per For gastric lavage: facility policy Type and size of tube inserted Patient’s response Technique used to assess tube placement Frequency and solution used for flush or irrigation Gastrointestinal assessment findings Net return from lavage Character and amount of drainage Type of suction and pressure setting used Vital signs and level of consciousness Results of gastric specimen testing Decontaminating agents instilled Time tube was removed Patient’s tolerance of removal

For gastric decompression: Type and size of tube inserted Patient’s response

Technique used to assess tube placement Character and amount of drainage Type of suction and pressure setting used Gastrointestinal assessment findings Nasal and oral hygiene measures Patient’s tolerance of decompression

For gastric compression: Type and size of tube inserted Patient’s response Technique used to assess tube placement Amount of air used to inflate balloon Confirmation of balloon inflation Pressure changes made during procedure Gastrointestinal assessment findings Nasal and oral hygiene measures Patient’s tolerance of compression

ATITESTING.COM 800.667.7531 ATITESTING.COM 800.667.7531 Documentation

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