Ch. 55: Care of Nasogastric Tubes (Nurs 309)

After a partial gastrectomy is performed, a client is returned from the postanesthesia care unit to the surgical unit with an IV solution infusing and a nasogastric tube in place. The nurse identifies that there is no nasogastric drainage for 30 minutes. There is an order for instillation of the nasogastric tube prn. The nurse should instill: 1. 30 mL of normal saline and continue the suction. 2. 20 mL of air and clamp the suction for 1 hour. 3. 50 mL of saline and increased pressure of the suction. 4. 15 mL distilled water and disconnect the suction for 30 minutes.

1. 30 mL of normal saline and continue the suction.

A client is admitted to the surgical unit from the post anesthesia care unit with a Salem sump nasogastric tube that is to be attached to wall suction. Which nursing action should the nurse implement when caring for this client? 1. Use normal saline to irrigate the tube. 2. Employ sterile technique when irrigating the tube. 3. Withdraw the tube quickly when decompression is terminated. 4. Allow the client to have small sips of ice water unless nauseated.

1. Use normal saline to irrigate the tube.

A client has a nasogastric tube connected to intermittent wall suction. The student nurse asks why the client's respiratory rate and depth has decreased. What is the nurse's best response? 1. "It's common for clients with uncomfortable equipment such as NG tubes to have a lower rate of breathing." 2. "The client may have a metabolic alkalosis due to the NG suctioning, and the decreased respiratory rate is a compensatory mechanism." 3. "Whenever a client develops a respiratory acid-base problem, decreasing the respiratory rate helps correct the problem." 4. "The client is hypo-ventilating because of anxiety, and we will have to stay alert for the development of respiratory acidosis."

2. "The client may have a metabolic alkalosis due to the NG suctioning, and the decreased respiratory rate is a compensatory mechanism."

Two hours after a subtotal gastrectomy, the nurse identifies that the drainage from the client's nasogastric tube is bright red. What should the nurse do first? 1. Notify the health care provider. 2. Clamp the nasogastric tube for one hour. 3. Determine that this is an expected finding. 4. Irrigate the nasogastric tube with iced saline.

3. Determine that this is an expected finding.

A client is to have gastric gavage. In which position should the nurse place the client when the nasogastric tube is being inserted? 1. Supine 2. Mid-fowler 3. High-fowler 4. Trendelenberg

3. High-fowler