A nurse is checking nasogastric tube position of a client receiving a long-term rapy of Omeprazole (Prilosec) by aspirating stomach contents to check for PH level. The nurse proves correct tube placement if PH level is?

Correct Answer: D. 5.5.

Gastric placement is indicated by a pH of less than 4 but may increase to between pH 4-6 if the patient is receiving acid-inhibiting drugs. Measuring the pH of stomach aspirate is considered more accurate than visual inspection. Stomach aspirate generally has a pH range of 0 to 4, commonly less than 4.

• Option A: The aspirate of respiratory contents is generally more alkaline, with a pH of 7 or more. Testing the pH of gastric aspirate to show pH ?5.5 is recommended first-line test to confirm correct placement of nasogastric tubes and reduce the risk of potentially fatal aspiration.
• Option B: The pH readings between 4.5 and 6.0 provided the greatest overall accuracy, however, there was only moderate agreement between observers at pH readings ?5.0. Compared with studies that have taken aspirate directly from the nasogastric tube, patients undergoing scope procedures had a lower sensitivity at the pH cut-off ?5.5 for identifying gastric aspirates for the whole group and in the presence and absence of antacid medications.
• Option C: Current healthcare guidelines recommend that the first-line test to confirm correct NGT placement prior to giving food or medications must be that the pH of an NGT aspirate is ?5.5 (acidic). Nevertheless, false-positive readings might occur if the tube is misplaced in the esophagus or false-negative readings (pH >5.5) may occur in patients who secrete less gastric acid, because of antacid medications, achlorhydria, or buffering by NGT feeds.