A nurse is contributing to the plan of care of a client who is postoperative following a gastrectomy and has a double-lumen nasogastric (NG) tube. Which of the following interventions should the nurse include in the plan?

Avoid replacing the NG tube if it is accidentally dislodged.

Irrigate the blue pigtail port with sterile saline.

Verify tube placement by injecting air into the larger lumen.

Avoid the nares when providing hygiene care.

Answer and Explanation

The Correct Answer is A

A. Avoid replacing the NG tube if it is accidentally dislodged: After a gastrectomy, improper placement or reinsertion of the NG tube can disrupt the surgical site, leading to complications such as bleeding, leakage, or perforation. If the tube is accidentally dislodged, the nurse should notify the surgeon or provider, as reinsertions in postoperative gastric surgery clients are typically performed under their direction.

B. Irrigate the blue pigtail port with sterile saline: The blue pigtail port (air vent) of a double-lumen NG tube (e.g., Salem sump) should not be irrigated with saline because it functions as an air vent to prevent suction from damaging the stomach lining.

C. Verify tube placement by injecting air into the larger lumen: Injecting air to verify NG tube placement is no longer considered a reliable or evidence-based practice. Placement should be verified by other methods, such as aspiration of gastric contents, pH testing, or radiographic confirmation, especially in postoperative clients.

D. Avoid the nares when providing hygiene care: Hygiene care for the nares is essential to prevent skin breakdown and discomfort in clients with an NG tube. Neglecting the nares could lead to excoriation, pressure injuries, or infection.

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Correct Answer is C

Explanation

A. Oatmeal: Oatmeal is often considered a bland and low-acid food that can be soothing for individuals with GERD. It's generally not a trigger for GERD symptoms and can be included in the diet of someone with this condition.

B. Non-fat milk: Non-fat milk and other low-fat dairy products are often recommended for individuals with GERD. However, individual tolerance varies, and some people might find that milk triggers their symptoms. It's best for the patient to monitor their own reactions to dairy products.

C. Chocolate: Chocolate is known to relax the lower esophageal sphincter, allowing stomach acid to flow back into the esophagus. For many people with GERD, chocolate can exacerbate symptoms and is typically advised to be avoided.

D. Apples: Apples are generally considered a safe and healthy food for individuals with GERD. However, some people may find that raw apples trigger their symptoms due to their natural acidity. Cooking or baking apples can often make them more tolerable for people with GERD.

A. Decreased potassium level B. Decreased calcium level C. Elevated magnesium level D. Elevated sodium level

Correct Answer is A

Explanation

A. Decreased potassium level
NG tube drainage can lead to hypokalemia (low potassium levels) due to the loss of gastric fluids, which contain significant amounts of potassium. This choice is correct.

B. Decreased calcium level
Calcium levels are not directly affected by NG tube drainage.

C. Elevated magnesium level
NG tube drainage does not typically lead to elevated magnesium levels.

D. Elevated sodium level
NG tube drainage can result in hyponatremia (low sodium levels) due to the loss of gastric fluids. Elevated sodium levels are not expected in this situation.

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A nurse is contributing to the plan of care of a client who is postoperative following a gastrectomy and has a double-lumen nasogastric (NG) tube. Which of the following interventions should the nurse include in the plan?

Nursing Test Bank

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A nurse is reinforcing discharge teaching with a client who has a new diagnosis of gastroesophageal disease (GERD). Which of the following foods should the nurse include in the list of foods the client should avoid?

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Explanation

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Correct Answer is A

Explanation

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