The client experiencing abdominal distention and severe vomiting has just had a nasogastric (NG) tube inserted. When teaching this client, which rationale for the use of the NG tube should the nurse include?
Decompressing the stomach
Administering medications
Determining the pH of the gastric secretions
Supplying nutrients via tube feedings
The Correct Answer is A
A. One of the primary purposes of inserting an NG tube is to decompress the stomach by removing gastric contents. In the case of abdominal distention and severe vomiting, excess gas and fluid accumulation in the stomach can contribute to discomfort and further vomiting. The NG tube provides a way to suction out these contents, relieving pressure and reducing symptoms.
B. NG tubes can also be used to administer medications directly into the stomach. This route is particularly useful when a client is unable to take medications orally due to vomiting or other gastrointestinal issues. Medications can be crushed and dissolved in liquid form before being administered through the NG tube.
C. In some situations, such as when assessing for gastrointestinal bleeding or checking for tube placement, it may be necessary to determine the pH of gastric secretions. Gastric aspirate obtained through the NG tube can be tested for acidity, which can help confirm that the tube is correctly positioned in the stomach and provide information about the client's digestive function.
D. While NG tubes can be used to supply nutrients via tube feedings, this is not typically the primary rationale for their use in the acute situation described (abdominal distention and severe vomiting). However, in cases where a client is unable to tolerate oral intake due to their condition, tube feedings can be administered through the NG tube to provide essential nutrients and maintain nutritional status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. This statement suggests that the client may have sleep-disordered breathing, such as obstructive sleep apnea, which can disrupt the client's sleep patterns and affect their overall sleep quality. The nurse may want to inquire further about the frequency and severity of the snoring, as well as any associated symptoms such as daytime fatigue or observed pauses in breathing during sleep.
B. This statement indicates that emotional stressors, such as arguments or conflicts, may impact the client's sleep patterns. The nurse may want to explore how often these conflicts occur and how they affect the client's ability to fall asleep or stay asleep. Additionally, the nurse may inquire about coping strategies or interventions that the client and their partner use to address conflicts and minimize their impact on sleep.
C. This statement suggests that the client experiences deep or heavy sleep, which may or may not be problematic depending on the context. While deep sleep can be indicative of good sleep quality, it may also raise concerns about the client's ability to awaken in the event of an emergency or the presence of a sleep disorder such as hypersomnia. The nurse may want to inquire further about the client's overall sleep duration, sleep latency, and any difficulties with waking up in the morning.
D. This statement suggests that the client may experience sleep talking, which is a common sleep phenomenon. While sleep talking itself is typically benign, it may indicate underlying sleep disturbances such as sleep fragmentation or abnormal sleep cycles. The nurse may want to ask additional questions to assess the frequency and content of the sleep talking, as well as any potential impacts on the client's sleep quality or daytime functioning.
Correct Answer is D
Explanation
D. This statement indicates an understanding of hospice care. Pain management is a crucial component of hospice care, and ensuring that patients have access to effective pain medication and symptom management is a priority. Hospice aims to maximize comfort and quality of life for patients, and providing pain relief is a fundamental aspect of this approach.
A. This statement suggests that the client may not fully understand the purpose of hospice care. Hospice care is generally provided to patients with a terminal illness who have a life expectancy of six months or less. The focus of hospice care is on comfort, quality of life, and symptom management rather than curative treatment. Planning for travel and activities like fishing may not align with the goals of hospice care.
B. This statement indicates a misunderstanding of hospice care. In hospice, patients are typically encouraged to have their loved ones and family members present and involved in their care, especially during the end-of-life period. Hospice care emphasizes emotional support, spiritual care, and the importance of family involvement during the dying process.
C. This statement may or may not indicate an understanding of hospice care, as it depends on the specific hospice setting and individual preferences. While some hospice programs may provide care in a hospital setting, many hospice services are delivered in the patient's home or in a hospice facility. The key aspect of hospice care is to provide comfort and support in a setting that best meets the patient's needs and wishes.
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