The nurse performs nasogastric (NG) tube insertion using a large-bore NG tube on a hospitalized client with a gastrointestinal bleed. During insertion, after the tube passes the nasopharynx, the client begins to cough and gag. Which action should the nurse take first? A)Ask the client to take several small sips of water B)Continue to slowly advance the tube until placement is reached C)Gently remove the tube and reinsert in the other naris if possible D)Pull back on the tube slightly and then pause to give the client time to breathe

Question

Quizplus · Accepted Answer

11ecbb05_cb70_a376_b433_2fda7076775d_MD0009_00 During NG tube insertion, the tube sometimes slips into the larynx or coils in the throat, which can result in coughing and gagging. The nurse should withdraw the tube slightly and then stop or pause while the client takes a few breaths. After the client stops coughing, the nurse can proceed with advancement (Option B), asking the client to take small sips of water to facilitate advancement to the stomach (Option A). The client should not be asked to swallow during coughing or aspiration may occur. If resistance or obstruction occurs during tube advancement, the nurse should rotate the tube while trying to advance it. If resistance continues, the tube should be withdrawn and inserted into the other naris if possible (Option C). Educational objective: Coughing and gagging commonly occur during NG tube insertion if the tube coils in the throat or slips into the larynx. When this happens, the nurse should pull back on the tube slightly and then pause to give the client time to recover and breathe before advancing the tube.

The Nurse Performs Nasogastric (NG) Tube Insertion Using a Large-Bore