A nurse is administering medication to a client via a nasogastric (NG) tube. The nurse crushes the medication and mixes it with water. Which of the following actions should the nurse take next?

The nurse should check the placement of the tube before administering any medication or fluid via an NG tube. This can prevent aspiration, infection, or injury to the client. The nurse can check the placement by aspirating gastric contents and measuring the pH, or by using a carbon dioxide detector.

Incorrect choices:

a) Flush the tube with 30 mL of water: Flushing the tube with water is correct, but it is not the next action. The nurse should flush the tube before and after administering the medication to prevent clogging and ensure delivery.

c) Clamp the tube for 30 minutes: Clamping the tube for 30 minutes is incorrect and can cause complications. The nurse should not clamp the tube unless ordered by the provider. Clamping the tube can increase the risk of reflux, aspiration, or tube displacement.

d) Elevate the head of the bed: Elevating the head of the bed is correct, but it is not the next action. The nurse should elevate the head of the bed at least 30 degrees before and during the administration of the medication to prevent aspiration and promote gastric emptying.

The first step in managing a missed or delayed medication is to check if another nurse has given or withheld the medication for some reason. This can prevent duplicate or omitted doses and ensure continuity of care. The nurse should also check if there are any contraindications or changes in orders for giving the medication.

Incorrect choices:

b) Give the medication as soon as possible: Giving the medication as soon as possible may be appropriate, but it is not the first action. The nurse should verify if another nurse has given or withheld the medication before administering it.

c) Document why the medication was delayed: Documenting why the medication was delayed is important, but it is not the first action. The nurse should verify if another nurse has given or withheld the medication and give it if indicated before documenting.

d) Report the incident to the charge nurse: Reporting the incident to the charge nurse may be necessary, but it is not the first action. The nurse should verify if another nurse has given or withheld the medication and give it if indicated before reporting.