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. 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.

A. Perform leg exercises every 2 hr: This is a good practice for any postoperative patient to prevent blood clots and maintain circulation. It's especially important for patients who might be relatively immobile due to surgery.

B. Irrigate the nasogastric tube every 4 to 8 hr: This is generally not a standard procedure. Nasogastric tubes are typically used for drainage or feeding. If there's a blockage or other issue, healthcare providers might intervene, but routine irrigation is not commonly done.

C. Maintain bed rest for 48 hr following surgery: While some rest might be necessary immediately after surgery, the trend in modern healthcare is to encourage mobility as soon as it's safe. Early mobilization can prevent complications such as blood clots and aid in recovery.

D. Encourage hourly use of an incentive spirometer while awake: Incentive spirometry is often encouraged postoperatively to prevent lung complications like atelectasis. Regular use helps keep the lungs expanded and functioning optimally.

E. Document the color, consistency, and amount of nasogastric drainage: This is crucial. Monitoring the drainage can provide important information about the patient's condition, such as bleeding or the effectiveness of the treatment. Any changes should be reported to the healthcare provider.