A nurse is caring for a client who has a nasogastric tube. The nurse should monitor the client for which of the following findings?

Fluid overload

Metabolic acidosis

Hyponatremia

Constipation

Answer and Explanation

The Correct Answer is C

A. Fluid overload: While NG tubes can be used for enteral feeding, they are often associated with fluid losses from suctioning or drainage rather than overload. Clients with NG tubes are more prone to dehydration and electrolyte imbalances.

B. Metabolic acidosis: NG tube suctioning primarily removes gastric contents, which are rich in hydrochloric acid. This can lead to metabolic alkalosis rather than acidosis due to excessive loss of acidic gastric secretions.

C. Hyponatremia: Prolonged NG tube suctioning or drainage can lead to the loss of sodium-rich gastric secretions, resulting in hyponatremia. Monitoring electrolyte levels and replacing lost fluids appropriately is essential to prevent imbalances.

D. Constipation: NG tubes are more commonly associated with diarrhea due to enteral feeding formulas rather than constipation. However, reduced oral intake and immobility could contribute to constipation in some cases.

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Correct Answer is A

Explanation

A. Obtain bottles of warm, sterile 0.9% sodium chloride solution: Evisceration requires immediate coverage of the exposed organs with sterile, saline-moistened dressings to prevent drying and infection. Using warm saline helps maintain tissue viability and minimizes damage.

B. Apply a firm pressure dressing across the client's abdomen: A firm pressure dressing is inappropriate, as it could cause further damage to the eviscerated organs and increase intra-abdominal pressure, leading to ischemia or perforation.

C. Attempt to reinsert the protruding viscera: Reinserting the eviscerated organs is contraindicated due to the high risk of contamination, trauma, and further complications. The nurse should instead protect the organs with moist dressings and prepare the client for emergency surgery.

D. Place the client in left lateral recumbent position: The client should be placed in a low Fowler’s position with knees slightly flexed to reduce tension on the abdominal wound and prevent further protrusion of organs. A left lateral recumbent position does not provide the same benefit.

A. "Place an aspirin in your ostomy pouch to control odor." B. "Your ostomy should start functioning in five days." C. "Empty your ostomy pouch when it becomes a third to halfway full." D. "Notify your provider if your stoma becomes dark red:"

Correct Answer is C

Explanation

A. "Place an aspirin in your ostomy pouch to control odor.": Aspirin should never be placed in an ostomy pouch, as it can damage the pouch material and irritate the stoma. Deodorizers or dietary adjustments are safer alternatives for odor control.

B. "Your ostomy should start functioning in five days.": An ostomy typically begins functioning within 2 to 4 days postoperatively, depending on bowel motility. Waiting five days without output could indicate an obstruction or ileus, requiring medical evaluation.

C. "Empty your ostomy pouch when it becomes a third to halfway full.": Keeping the pouch from becoming too full prevents leaks, discomfort, and excessive pressure on the stoma. This practice helps maintain skin integrity and ostomy function.

D. "Notify your provider if your stoma becomes dark red.": A dark red stoma is normal and indicates good blood supply. However, a stoma that turns pale, dusky, or black requires immediate medical attention, as it suggests compromised circulation and possible necrosis.

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A nurse is caring for a client who has a nasogastric tube. The nurse should monitor the client for which of the following findings?

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