Nurse Aaron is inserting a nasogastric tube to a stroke client. He understands that best position for insertion is?

Correct Answer: D. High Fowler’s.

The best position during a nasogastric tube insertion is sitting or High Fowler’s position in order to prevent the risk of aspiration. Position patient sitting up at 45 to 90 degrees (unless contraindicated by the patient’s condition), with a pillow under the head and shoulders. This allows the NG tube to pass more easily through the nasopharynx and into the stomach.

• Option A: Low fowler’s position is similar to the supine position, and is considered the best position for rest. In a low-Fowler’s position, the patient’s head is inclined at a 15- or 30-degree angle. Insertion of NGT could be particularly difficult in this position. Low Fowler’s position is typically used to reduce lower back pain, during administration of drugs, or during tube feeding.
• Option B: Insertion of NGT would be impossible in Sim’s position. The Sims position is a standard position in which the patient lies on their left side, with right hip and knees bent. The lower arm is behind the back, the thighs flexed. The left knee is slightly tilted. The right arm is positioned comfortably in front of the body, the right arm is rested behind the body. This is also known as “lateral” position. Sim’s position is often used for rectal examination and treatments.
• Option C: Placing the patient in Trendelenburg position for NGT insertion is highly inappropriate. In Trendelenburg position, the patient is supine on the table with their head declined below their feet at an angle of roughly 16°. Trendelenburg position is typically used for lower abdominal surgeries including colorectal, gynecological, and genitourinary procedures as well as central venous catheter placement.