Page 128 - Modul English Communication In Nursing

b. Observe both X-rays to decide which illustrates the correct or incorrect placement of NGT.

Ns. Grace : “All right, now that you’ve been familiar with the anatomy. I’m going to explain to you
how the tube was initially placed and how it looks based on the latest X-ray. “
Mr. Hari : “Please go slowly so I can follow you well.”
Ns. Grace : “No worries, Sir. I’ll make it easy for you to understand.”
“So, let’s compare these two X-rays from your
wife. This one was taken after the insertion,
which was 2 days ago. While this one was taken
this morning after several complaints your wife has.”
“You see, the X-ray from Day 1 shows the tube was
correctly positioned. The tube safely entered the trachea
and bisected the carina down to the midline level of the
diaphragm. We can clearly see it here, it is visibly seen here;
adequately below the left hemidiaphragm. The tip of the
NGT is 10 cm beyond the gastroesophageal junction and therefore is likely to be within
the stomach.”
Mr. Hari : “Yes, and so… what does it mean?”
Ns. Grace : “When the tube is in this position, the food is going to enter the stomach properly and
no complication is going to occur. Nothing to worry.”
Mr. Hari : “All right, I’m trying to follow you.”
Ns. Grace : “Great. This morning, however, we noticed the fixation tape was not properly attached
we confirmed with your wife and she said she said she feels a kind of pressure on her
throat since yesterday.”
Mr. Hari : “Yeah, she said that. I don’t know if it is the cause, but I think it was several nights before
when she was deep in her sleep. She accidentally brushed her nose so the tape was
loosened. I didn’t give it much thought so I simply tried to attach it back to its place. Did
I make a mistake?”
Ns. Grace : “Well, Sir. Although it seems simple, when the tube is roughly misplaced by an
accidental agitation such as what happened that night the inner tube placed inside the
stomach might also shift from its original position; resulting in some effects.”
Mr. Hari : “I’m so sorry. I should’ve informed it right away to the night shift nurse.”
Ns. Grace : “No worries, Sir. That’s why, this morning we gave your wife an X-ray to check the
position of the NGT. And, when we compare it to the previous X-ray, you will notice that
although the tube remains appropriately bisecting the carina without bending over to
either the main right or main left bronchus, the tip of the tube is inadequately entered
the diaphragm.”
Mr. Hari : “Ahhh… I see. That’s why it looks shorter here.”
Ns. Grace : “Yes, you see the difference now. It looks shorter now as it is less than 10 cm from the
gastroesophageal junction.”
Mr. Hari : “So, what will happen now?”

pg. 118