A nurse is caring for four clients who have drainage tubes. The nurse should identify the client who has which of the following tubes as being at risk for hypokalemia?

A nephrostomy tube to a drainage bag

An NG tube to suction

An indwelling urinary catheter to gravity drainage

A chest tube to water-seal drainage

Answer and Explanation

The Correct Answer is B

A. A nephrostomy tube to a drainage bag:
A nephrostomy tube drains urine from the kidney to a drainage bag. While it's essential for urinary drainage, it doesn't lead to significant potassium loss, as potassium is primarily excreted through the urine.

B. An NG tube to suction:
An NG tube (Nasogastric tube) is inserted through the nose into the stomach. When connected to suction, it can remove stomach contents, including gastric acid and potassium. Excessive suctioning can lead to significant potassium loss, potentially causing hypokalemia.

C. An indwelling urinary catheter to gravity drainage:
An indwelling urinary catheter drains urine from the bladder into a drainage bag by gravity. While potassium can be found in urine, the drainage through a catheter does not cause significant potassium loss unless there are underlying kidney issues, which are not specified in this scenario.

D. A chest tube to water-seal drainage:
A chest tube removes air or fluid from the pleural space around the lungs. While chest tubes are vital for lung expansion, they don't result in significant potassium loss as they are not connected to body fluids rich in potassium, like gastric acid or urine.

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Correct Answer is D

Explanation

A. Place the client in a supine position.
Placing the client in a high Fowler's position (sitting upright) is the appropriate position for inserting a nasogastric tube. This position helps facilitate the passage of the tube through the nasopharynx and into the esophagus and stomach.

B. Withdraw the tube if the client gags during insertion.
Gagging during insertion is a normal response. Advancing the tube slowly and having the client swallow can help pass the tube through the nasopharynx.

C. Measure the tube for insertion from the tip of the nose to the umbilicus.
The correct measurement for insertion is from the tip of the nose to the earlobe and then down to the xiphoid process (not the umbilicus).

D. Instruct the client to place his chin to his chest and swallow.
This instruction is appropriate. Asking the client to flex their head slightly forward and swallow helps guide the tube into the esophagus.

A. "I will use caution when eating high fiber foods." B. "I will empty my pouch when it becomes one third full." C. "I will be certain to take enteric-coated medications." D. "I will change my entire pouch system at least weekly."

Correct Answer is C

Explanation

A. "I will use caution when eating high fiber foods."Clients with an ileostomy should be cautious with high-fiber foods as they can cause blockages.

B. "I will empty my pouch when it becomes one third full."
This statement is correct. Regularly emptying the pouch prevents it from becoming too heavy and ensures comfort for the client.

C. "I will be certain to take enteric-coated medications."This statement indicates a need for further teaching. Enteric-coated medications are designed to dissolve in the intestine, but with an ileostomy, the medication may pass through the digestive system too quickly to be absorbed effectively. Clients should be advised to consult their healthcare provider about medication forms, as liquid or non-enteric-coated medications may be more appropriate.

D. "I will change my entire pouch system at least weekly."
This statement is correct. Changing the pouch system regularly helps maintain hygiene and prevents skin irritation.

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A nurse is caring for four clients who have drainage tubes. The nurse should identify the client who has which of the following tubes as being at risk for hypokalemia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is C

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