A nurse is caring for a client who has an NG tube due to an intestinal obstruction. Using the nursing process for clinical decision making, which of the following actions should the nurse take to maintain NG patency?

Place the client on his right side if tube resistance occurs.

Check the tube patency every 4 hr.

Flush the tube with 50 mL of 0.9% sodium chloride irrigation every 8 hr.

Maintain the client in a supine position.

Answer and Explanation

The Correct Answer is B

A) Place the client on his right side if tube resistance occurs: Positioning the client on the right side can help facilitate gastric emptying, but it is not a primary action to ensure NG tube patency. If tube resistance occurs, the nurse should assess and address the resistance more directly.

B) Check the tube patency every 4 hr: Regularly checking the tube patency ensures that the NG tube remains open and functional, preventing blockages and ensuring continuous decompression or feeding as required.

C) Flush the tube with 50 mL of 0.9% sodium chloride irrigation every 8 hr: Flushing the tube helps maintain patency, but the amount and frequency may vary based on facility protocols. Flushing every 8 hours might not be frequent enough to prevent blockages.

D) Maintain the client in a supine position: Keeping the client in a supine position is not recommended for maintaining NG tube patency and may increase the risk of aspiration. A semi-Fowler's position is usually preferred to promote drainage and reduce aspiration risk.

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Correct Answer is A

Explanation

A) Orthostatic hypotension:
Tamsulosin, an alpha-blocker used to treat benign prostatic hypertrophy, can cause orthostatic hypotension, which is a significant adverse effect. This condition involves a sudden drop in blood pressure when standing up, leading to dizziness or fainting. It's important for clients to report these symptoms to their healthcare provider for potential adjustment of medication or additional instructions on managing this side effect.

B) Muscle tenderness:
Muscle tenderness is not commonly associated with tamsulosin. While muscle pain can occur with other medications, it is not a known adverse effect of tamsulosin and does not require immediate notification to the provider in the context of this medication.

C) Decreased heart rate:
Tamsulosin does not typically cause bradycardia (decreased heart rate). This side effect is more associated with beta-blockers or other cardiac medications, rather than alpha-blockers like tamsulosin. Reporting this would be relevant for those other medications but not for tamsulosin.

D) Oliguria:
Oliguria, or decreased urine output, is not a known adverse effect of tamsulosin. Tamsulosin helps improve urine flow in clients with benign prostatic hypertrophy, so reporting oliguria would not be pertinent in this context. Instead, it could indicate another underlying issue.

A. Provide detailed directions for the client's expected behavioral changes. B. Request the client write down an evaluation of personal strengths. C. List alternative interpretations of the client's illogical thinking. D. Encourage the client to participate in group recreational activities to help concentration.

Correct Answer is B

Explanation

A) Provide detailed directions for the client's expected behavioral changes
Giving detailed directions may overwhelm the client, increasing anxiety. It's more effective to offer support and simple, clear guidance to reduce stress.

B) Request the client write down an evaluation of personal strengths
Encouraging the client to focus on personal strengths can boost self-esteem and resilience, helping them cope with anxiety by promoting a positive self-image and reinforcing their ability to manage stress.

C) List alternative interpretations of the client's illogical thinking
While reframing thoughts can be helpful, this approach might be too confrontational initially. It's important to build trust and allow the client to explore thoughts at their own pace.

D) Encourage the client to participate in group recreational activities to help concentration
While recreational activities can be beneficial, they may not directly address anxiety management. Individual reflection on strengths can be a more immediate way to enhance coping skills.

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A nurse is caring for a client who has an NG tube due to an intestinal obstruction. Using the nursing process for clinical decision making, which of the following actions should the nurse take to maintain NG patency?

Nursing Test Bank

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