Enteral Nutrition
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Safety
- A health care provider’s order is needed to remove a feeding tube.
Equipment
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Disposable waterproof pad
Tissues
Clean gloves
Stethoscope
Basin or disposable bag
Oral hygiene supplies
PrintableDelegation
The skill of feeding tube removal may not be delegated to nursing assistive personnel (NAP). However, NAP may assist the nurse with patient positioning and comfort measures during tube removal.
Preparation
- Assess the patient’s knowledge of the procedure.
- Assess the patient’s mental status, ability to cooperate with the procedure, sedation, presence of cough and gag reflex, ability to swallow, critical illness, and presence of an artificial airway.
- Perform a physical assessment of the abdomen.
- Explain the procedure to the patient, including any sensations he or she will feel during tube removal.
Follow-up
- Auscultate for presence of bowel sounds.
- Palpate the patient's abdomen periodically. Note any distention, pain, or rigidity.
- Inspect the condition of the patient's nares.
- Ask the patient if he or she has any pain. Assess pain using a scale of 0 to 10, or use the scale specified by your agency.
Documentation
- Record removal of the tube and the patient’s tolerance.
- Report any type of unexpected outcome and the interventions performed.
Review Questions
1. How might the nurse minimize the patient’s anxiety when removing a nasogastric tube?
Administer a mild sedative prescribed by the patient’s health care provider.- Ask the patient’s caregiver to emotionally support the patient during the removal.
Provide reassurance of what will happen during the procedure and talk the patient through the process.- Instruct the patient to take deep, calming breaths while revisiting a pleasant memory.
2. What would minimize the nurse’s risk for contamination during the removal of a nasogastric tube?
- Wearing treatment gloves
- Providing the patient with an emesis basin
- Protecting the patient’s chest with an absorbent towel
- Discarding any soiled tissues in the biohazard receptacle
3. What will the nurse need before removing a patient’s nasogastric tube?
- Evidence of hypoactive bowel sounds in all quadrants
- Absence of abdominal pain and distention
- Assurance that the patient can pass flatus
- A health care provider’s order
4. What patient care might the nurse delegate to nursing assistive personnel (NAP) when a patient's nasogastric tube is removed?
- Assessing the patient for abdominal distention
- Providing the patient with mouth care
- Documenting tube removal
- Checking for bowel sounds
5. Why does the nurse kink the nasogastric tube before removing it from a patient?
- To suppress the cough reflex
- To keep any fluid from flowing out
- To hinder the gag reflex
- To prevent transmission of microorganisms
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