Nursing Component Task
Nursing procedures & clinical learning

General Nursing (RGN)

FEEDING A PATIENT PER NASO-GASTRIC TUBE

Naso-gastric tube feeding delivers prescribed nutrition, fluids, and medicines into the stomach when oral intake is unsafe or insufficient. Safe practice requires confirmation of tube position using the approved method before every feed, upright positioning, controlled administration, flushing, and monitoring for intolerance.

Purpose

  • Provide prescribed nutrition and hydration
  • Administer enteral medicines when appropriate
  • Support patients who cannot meet needs orally while maintaining gastrointestinal function

Indications

  • A correctly placed and authorized naso-gastric tube
  • Inability to meet nutritional needs orally with a functioning gastrointestinal tract
  • Prescribed enteral feed, water, or medication

Equipment

  • Prescribed enteral feed and water
  • Enteral feeding syringe or feeding pump and giving set
  • pH testing strip and aspirate equipment according to policy
  • Clean gloves, apron, and protective sheet
  • Tube clamp and enteral connectors
  • Graduated container and emesis receptacle
  • Intake-output and feeding record

Preparation

  • Check the tube’s external marking, fixation, nostril and skin condition, and recent placement documentation.
  • Assess bowel sounds, abdominal distension, stool pattern, hydration, and aspiration risk as directed by policy.

Procedure steps

  • Verify the order, patient identity, prescribed feed, volume, rate, allergies, fluid restrictions, and tube type.
  • Explain the feed, assess alertness, nausea, abdominal status, aspiration risk, and head-of-bed requirements.
  • Perform hand hygiene, prepare the feed at the correct temperature, check expiry and integrity, and use an enteral-only system.
  • Position the patient with the head of bed elevated at least 30–45 degrees unless contraindicated.
  • Confirm tube position immediately before feeding using the approved local method, usually aspirate pH and external-length assessment; do not rely on the whoosh test.
  • Stop and seek review if position cannot be confirmed, the tube has migrated, aspirate is abnormal, or respiratory symptoms are present.
  • Flush the tube with the prescribed water volume before feeding, using the correct enteral syringe and gentle technique.
  • Administer the prescribed feed by gravity or pump at the ordered rate; do not force feed or use excessive pressure.
  • Monitor the patient for coughing, breathlessness, vomiting, abdominal distension, pain, diarrhoea, and feed intolerance; pause and escalate concerns.
  • Flush after feeding according to policy, keep the patient elevated for the prescribed period, clean equipment, document feed and response, and perform hand hygiene.

Precautions

  • Do not commence a feed if tube placement is uncertain; confirm by approved policy and escalate.
  • The air-auscultation or whoosh test is not a reliable method of confirming tube position.
  • Use enteral equipment and connectors that cannot be inadvertently connected to IV lines.
  • Follow local guidance for gastric residuals; do not make decisions from residual volume alone without clinical context.

Aftercare

  • Maintain head elevation, provide mouth and nasal care, and check the tube fixation.
  • Teach the patient to report nausea, pain, coughing, breathlessness, or tube displacement.

Documentation

  • Record feed type, volume, route, rate, water flushes, tube position check, patient tolerance, and intake-output.
  • Document interruptions, vomiting, aspiration signs, tube displacement, and escalation.

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

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