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 C

Explanation

A) "After chewing an antacid, wait 1 hour before drinking water.": This is incorrect advice as drinking water after taking an antacid can help wash the medication down and ensure it reaches the stomach effectively. Waiting an hour to drink water is unnecessary and does not benefit GERD management.

B) "Plan to have a bedtime snack each evening.": Having a bedtime snack can exacerbate GERD symptoms by increasing stomach acid production just before lying down. Clients with GERD should avoid eating close to bedtime to minimize symptoms.

C) "Elevate the head of your bed 12 inches.": Elevating the head of the bed helps prevent stomach acid from flowing back into the esophagus during sleep, which can reduce nighttime GERD symptoms. This is a recommended non-pharmacological intervention for managing GERD.

D) "Eat a sugar-free peppermint when symptoms occur.": Peppermint can relax the lower esophageal sphincter, potentially worsening GERD symptoms by allowing stomach acid to reflux into the esophagus. Therefore, peppermint is not recommended for managing GERD symptoms.

A. "I will offer my child apple juice instead of milk." B. "I should continue to feed my child when he pushes food out with his tongue." C. "I will provide his favorite food as a reward for good behavior." D. "I should increase my child's vitamin A intake by feeding him raw carrot slices."

Correct Answer is B

Explanation

A) "I will offer my child apple juice instead of milk.": Offering apple juice instead of milk is not ideal for a toddler with failure to thrive. Milk is a better source of essential nutrients like calcium and vitamin D, which are important for growth and development. Juice can contribute to empty calories and should be limited.

B) "I should continue to feed my child when he pushes food out with his tongue.": This statement indicates an understanding of the importance of addressing feeding difficulties. In toddlers with Down syndrome, it is common to experience difficulties with feeding and swallowing. Continuing to offer food and using techniques to encourage eating, even when the child initially pushes food out, can help ensure adequate nutritional intake and support growth.

C) "I will provide his favorite food as a reward for good behavior.": Using food as a reward can lead to unhealthy eating habits and an association of food with behavior rather than hunger and nutrition. It’s better to use non-food rewards to encourage positive behavior.

D) "I should increase my child's vitamin A intake by feeding him raw carrot slices.": While vitamin A is important, raw carrots can be difficult for toddlers, especially those with developmental delays or oral-motor difficulties, to chew and swallow. Cooked carrots or other vitamin A-rich foods might be a safer option.

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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?

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