A patient has a nasogastric (NG) tube following esophagectomy. Following standards of practice, which of the following postoperative instructions should the nurse question the surgeon about?
Calling the physician for any bright red blood in the NG tube
Keeping the NG tube taped and secured to the patient's nares
Notifying the physician for a temperature under 100.5°F
Irrigating the NG tube with 30 mL of normal saline every 6 hours
The Correct Answer is C
A. It is appropriate to notify the physician if bright red blood is found in the NG tube, as this could indicate bleeding, which requires prompt medical attention.
B. It is standard practice to keep the NG tube taped and secured to the patient’s nares to prevent dislodgement and ensure proper function.
C. A temperature under 100.5°F is generally not a cause for concern postoperatively, unless it is persistent or accompanied by other signs of infection. Typically, a low-grade fever is expected after surgery, but further investigation is only warranted for higher fevers or other concerning symptoms.
D. Irrigating the NG tube every 6 hours with 30 mL of normal saline is standard practice to ensure patency of the tube and prevent clogging.
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Related Questions
Correct Answer is D
Explanation
A. While obesity can contribute to various health issues, it is not a direct cause of esophageal varices.
B. Smoking is harmful to overall health, but it is not specifically known to cause esophageal varices.
C. High blood pressure, especially systemic hypertension, is not a direct cause of esophageal varices. However, portal hypertension, which can be caused by liver disease, is the main factor in the development of esophageal varices.
D. Chronic liver disease, particularly cirrhosis, leads to portal hypertension, which in turn causes the veins in the esophagus to become engorged and prone to bleeding, resulting in esophageal varices. This is the most appropriate cause for esophageal varices.
Correct Answer is D
Explanation
A. 3% sodium chloride is a hypertonic solution used to treat severe hyponatremia and should not be used as a substitute for TPN.
B. Lactated Ringer's is an isotonic solution typically used for fluid resuscitation, but it lacks the necessary components (glucose, amino acids) that are found in TPN.
C. 0.9% sodium chloride is an isotonic saline solution and can be used for hydration, but it does not provide the calories and nutrients that the client is receiving through TPN.
D. Dextrose 10% in water is the best choice in this scenario. It provides glucose for energy and can help maintain blood sugar levels until the next TPN solution is available. It is commonly used as a temporary substitute for TPN to prevent hypoglycemia.
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