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For my patient who has a nasogastric (NG) tube, the health care provider wrote an order that reads, "flush NG tube p.r.n." She didn't specify what solution to use. Is water acceptable, or should I stick to 0.9% sodium chloride solution?-N.R., TEX.


As a general rule, an NG tube should be flushed every 4 to 6 hours with either water or 0.9% sodium chloride to keep it patent. Document the amount, color, and type of NG tube drainage every 8 hours, according to policy or as otherwise directed.1


The order you describe is incomplete, however-it should specify the flush solution and the amount to use. In addition, "p.r.n." is too vague-as needed for what reason?


Contact the prescriber to clarify this order. Although water is generally acceptable for NG tube flushing, in this case she may have a reason to prefer 0.9% sodium chloride; for example, to minimize electrolyte loss through gastric drainage.


Also find out whether your facility has a policy and procedure for maintaining NG tubes. If an order directs you to flush "according to policy," you'd follow those guidelines.


For the safety of your patients, never try to guess what the prescriber means. If you have any questions, insist on a clarification.


1. Smeltzer SC, et al. Brunner Suddarth's Textbook of Medical-Surgical Nursing, 11th edition, Vol. 1. Philadelphia, Pa., Lippincott Williams and Wilkins, 2008. [Context Link]