Fundamental CMS
Exam (Study
Guide)
, Fundamental CMS Exam
Gastrointestinal Therapeutic Procedures:
Nasogastric Tube: Preparation
o DON clean gloves
o VERIFY patient using two identifiers
o LISTEN to bowel and breath sounds
o Rip 3 pieces of tape, plus one piece torn halfway down the center
o SIT THE PATIENT UP in High Fowler’s position
o If hooking up to suction, verify that the suction equipment works
o Have the tissues and emesis basin readily available for the patient
o ALERT the patient that the procedure will be uncomfortable and may cause gagging and
o nasal discomfort.
o OBTAIN verbal consent
o LOOK in the back of the patient’s throat and inside the nares with a penlight
o ASK the patient to swallow
NG tube placement- Clean technique
Prior to ask AND look the patient if they have nasal polyps, deviated sputum, nose bleeds, fractured nose/oral,
anticoagulant therapy.
o Gather supplies, making sure gastric decompression and lavage, are ready for suctioning or irrigation.
o Measure the distance of tube from the tip of the nose to earlobe to xiphoid process.
o Patient is in high fowlers position. Raise the bed to hip level.
o With a penlight look into the patients nose and mouth. Assess gag reflex against the uvula.
o Listen to lung and abdominal sounds
o Dip the tube 3 to 4 inches into a glass of room temperature water a water-soluble lubricant (no
petroleum jelly) the tip of the tube before inserting.
o Patient first tilts their head back, insert NG tube into you reach the posterior nasopharynx, aiming the tube
towards the ear.
o Relax and flex head/chin toward chest and start taking small sips of water
o Encourage the patient to swallow sips of water and rotate the tube and rotate the tube while inserting.
, o Avoid inserting while the patient is inhaling.
Exam (Study
Guide)
, Fundamental CMS Exam
Gastrointestinal Therapeutic Procedures:
Nasogastric Tube: Preparation
o DON clean gloves
o VERIFY patient using two identifiers
o LISTEN to bowel and breath sounds
o Rip 3 pieces of tape, plus one piece torn halfway down the center
o SIT THE PATIENT UP in High Fowler’s position
o If hooking up to suction, verify that the suction equipment works
o Have the tissues and emesis basin readily available for the patient
o ALERT the patient that the procedure will be uncomfortable and may cause gagging and
o nasal discomfort.
o OBTAIN verbal consent
o LOOK in the back of the patient’s throat and inside the nares with a penlight
o ASK the patient to swallow
NG tube placement- Clean technique
Prior to ask AND look the patient if they have nasal polyps, deviated sputum, nose bleeds, fractured nose/oral,
anticoagulant therapy.
o Gather supplies, making sure gastric decompression and lavage, are ready for suctioning or irrigation.
o Measure the distance of tube from the tip of the nose to earlobe to xiphoid process.
o Patient is in high fowlers position. Raise the bed to hip level.
o With a penlight look into the patients nose and mouth. Assess gag reflex against the uvula.
o Listen to lung and abdominal sounds
o Dip the tube 3 to 4 inches into a glass of room temperature water a water-soluble lubricant (no
petroleum jelly) the tip of the tube before inserting.
o Patient first tilts their head back, insert NG tube into you reach the posterior nasopharynx, aiming the tube
towards the ear.
o Relax and flex head/chin toward chest and start taking small sips of water
o Encourage the patient to swallow sips of water and rotate the tube and rotate the tube while inserting.
, o Avoid inserting while the patient is inhaling.
