Question

A nurse is caring for a client who has a nasogastric (NG) tube. The nurse tests the pH of the secretions to determine if the tube is correctly placed. The nurse should expect to aspirate a sample with a pH of

Answer 1

Gastric, Testing the pH of a stomach aspirate to a value of 5.5 is the first-line diagnostic to assure correct nasogastric tube insertion and reduce the danger of potentially fatal aspiration.

Adult patients who had bronchoscopy or gastroscopy and had two (one fresh and one frozen) bronchial and esophageal samples or two bronchial and salivary samples each were included in this prospective observational study.

Kappa (k) statistics were used to determine the level of observer agreement for the pH of fresh and frozen samples. To distinguish between gastric and non-gastric aspirates, the sensitivities and specificities at pH 5.5 and the area under the receiver operating characteristics (ROC) curve at various pH cut-offs were computed.97 individuals underwent a gastroscopy, and 106 underwent a bronchoscopy. In 57/92 (62%) of the paired fresh and frozen stomach samples, there was total agreement between the observers (k=0.496, 95% CI 0.364 to 0.627).

The specificity of a pH 5.5 was 79% (95% CI 74 to 84), while the sensitivity of a pH 5.5 to accurately identify stomach samples was 68% (95% CI 57 to 77). Regardless of whether patients were using antacids or not, the overall accuracy to correctly categorize samples was between 76% and 77%. At various pH cut-offs, the ROC curve's area under the curve was 0.74.

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