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 D

Explanation

A. Docusate:
Docusate is a stool softener used to prevent constipation and straining during bowel movements. It is not typically used as a treatment for acute exacerbation of ulcerative colitis.

B. A bowel cathartic medication:
Bowel cathartic medications are laxatives that promote bowel movements. They are generally not used to treat acute exacerbation of ulcerative colitis and can sometimes worsen symptoms in individuals with inflammatory bowel disease.

C. Aspirin:
Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that can worsen symptoms of inflammatory bowel disease and is generally avoided in individuals with ulcerative colitis.

D. A corticosteroid medication:
This is the correct answer. Corticosteroids, such as prednisone, are often used to reduce inflammation in the colon during acute exacerbations of ulcerative colitis. They help in managing the symptoms and promoting healing of the inflamed intestinal lining.

A. Thirty minutes before breakfast and the evening meal B. One hour before breakfast and the evening meal C. At the time the client takes an antacid D. At the time the client takes a proton-pump inhibitor

Correct Answer is A

Explanation

A. Thirty minutes before breakfast and the evening meal: This is the correct option. Sucralfate is typically administered 30 minutes before meals or on an empty stomach to allow it to form a protective coating over ulcers without interference from food.

B. One hour before breakfast and the evening meal: This choice is not typical for sucralfate administration. Waiting for a whole hour before meals might cause the patient to miss the window where the medication is most effective.

C. At the time the client takes an antacid: Administering sucralfate simultaneously with an antacid is not recommended because antacids can interfere with its effectiveness by neutralizing the stomach acid needed to activate sucralfate.

D. At the time the client takes a proton-pump inhibitor: Sucralfate should not be administered simultaneously with proton-pump inhibitors. Proton-pump inhibitors reduce stomach acid, which is needed to activate sucralfate.

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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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Correct Answer is D

Explanation

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Correct Answer is A

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