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A nurse is assessing for correct placement of a client's NG feeding tube prior to administering a bolus feeding.

Which of the following actions should the nurse take?

Insert air in the tube and listen for gurgling sounds in the epigastric area

Aspirate contents from the tube and verify the pH level

Review the medical record for previous x-ray verification of placement

Auscultate the lungs for adventitious breath sounds

Answer and Explanation

The Correct Answer is B

Aspirate contents from the tube and verify the pH level.

A. This is an incorrect action. Inserting air in the tube and listening for gurgling sounds in the epigastric area is not a reliable method to confirm NG tube placement, as it can produce falsepositive results due to air entering the stomach or intestines.
B. This is a correct action. Aspirating contents from the tube and verifying the pH level is a valid method to confirm NG tube placement, as gastric contents typically have a pH of less than 5.5, while intestinal or respiratory contents have a higher pH.
C. This is an incorrect action. Reviewing the medical record for previous x-ray verification of placement is not sufficient to confirm NG tube placement, as the tube can migrate or become dislodged after insertion. X-ray verification should be done initially and whenever there is doubt about the tube's position.
D. This is an incorrect action. Auscultating the lungs for adventitious breath sounds is not a specific method to confirm NG tube placement, as it can indicate other conditions such as pneumonia or pulmonary edema. It can also miss signs of respiratory complications due to NG tube misplacement, such as pneumothorax or bronchial obstruction.

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Correct Answer is A

Explanation

Choice A rationale:

Preschoolers with celiac disease need to avoid gluten-containing grains such as wheat, barley, and rye. Corn tortilla with black beans is a suitable option as it does not contain gluten and provides essential nutrients.

Choice B rationale:

Whole wheat pasta contains gluten, which should be avoided by individuals with celiac disease. This option is inappropriate for the preschooler with celiac disease.

Choice C rationale:

Low sodium vegetable soup with barley contains gluten, which is not suitable for a child with celiac disease. Barley is a gluten-containing grain and should be avoided.

Choice D rationale:

Rye bread contains gluten and is not appropriate for a preschooler with celiac disease. This option is not suitable for the child's dietary needs.

A. Initiate IV access on the palmar side of the client's wrist. B. Insert a larger gauge IV catheter to prevent phlebitis. C. Choose the client's dominant arm for IV access whenever possible. D. Select a site proximal to previous venipuncture sites.

Correct Answer is D

Explanation

Choice A rationale:

Initiating IV access on the palmar side of the client's wrist is not recommended. This area has many delicate structures and is prone to complications such as nerve damage. Choosing a safer, larger vein proximal to the wrist is a better practice.

Choice B rationale:

Inserting a larger gauge IV catheter is not necessary unless the client's condition or prescribed therapy specifically requires it. Using an unnecessarily large catheter can cause discomfort and increase the risk of complications, such as phlebitis.

Choice C rationale:

Choosing the client's dominant arm for IV access whenever possible is not a universally appropriate guideline. The choice of the arm should depend on the condition of the veins and the individual patient's circumstances. The nurse should assess both arms and choose the one with the most suitable and accessible veins.

Choice D rationale:

Selecting a site proximal to previous venipuncture sites is the correct action. Repeated venipuncture in the same area can cause phlebitis and compromise the integrity of the veins. Selecting a new site proximal to previous punctures helps to preserve vein health and reduce the risk of complications.

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A nurse is assessing for correct placement of a client's NG feeding tube prior to administering a bolus feeding. Which of the following actions should the nurse take?

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A nurse is assessing for correct placement of a client's NG feeding tube prior to administering a bolus feeding.

Which of the following actions should the nurse take?