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

Answer and Explanation

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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Correct Answer is ["C","E"]

Explanation

A. Taking all drugs one hour before mealtime is not typically recommended for patients recovering from upper G.I. bleeding. Medications like proton pump inhibitors or antacids may be prescribed to reduce stomach acid, but timing varies. The patient should follow the specific instructions given by the healthcare provider regarding medication administration, especially in the context of G.I. issues.
B. Limiting alcohol intake is important for general health, but after an episode of upper G.I. bleeding, alcohol should be avoided or minimized entirely. Alcohol can irritate the stomach lining and increase the risk of further bleeding. The healthcare provider may recommend complete abstinence from alcohol during recovery.
C. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can cause irritation of the stomach lining and increase the risk of bleeding, so they should be avoided after an episode of upper G.I. bleeding. This is crucial for preventing recurrence of bleeding.
D. Taking aspirin with milk or bread does not negate its potential for irritation or bleeding risk. Patients recovering from upper G.I. bleeding should avoid aspirin entirely unless specifically directed otherwise by the healthcare provider.
E. Only taking drugs prescribed by the healthcare provider is essential. Over-the-counter medications, especially NSAIDs, should be avoided unless directed by a healthcare provider, as they can exacerbate the risk of further G.I. bleeding.

A. Hypermagnesemia B. Hyponatremia C. Hypophosphatemia D. Hyperkalemia

Correct Answer is C

Explanation

A. Hypermagnesemia is not typically associated with refeeding syndrome. In fact, hypomagnesemia is more common due to the rapid shift of electrolytes and the body's increased demand during refeeding.
B. Hyponatremia is not a hallmark of refeeding syndrome. This condition more commonly leads to electrolyte imbalances like hypophosphatemia, hypokalemia, and hypomagnesemia rather than low sodium levels.
C. Hypophosphatemia is a hallmark finding in refeeding syndrome. As the body shifts from catabolic to anabolic states during refeeding, phosphorus is rapidly used in cellular processes, and its levels drop, which can lead to muscle weakness, respiratory failure, and other complications.
D. Hyperkalemia is not typically associated with refeeding syndrome. The condition is more likely to cause hypokalemia due to the shift of potassium into cells during the anabolic process after refeeding.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is preparing a teaching plan for a patient being discharged after an acute episode of upper G.I. bleeding. What important information should the teaching plan include? Select all that apply.

Correct Answer is ["C","E"]

Explanation

A nurse is caring for a client who is receiving total parenteral nutrition and develops refeeding syndrome. The nurse should expect which of the following laboratory findings?

Correct Answer is C

Explanation

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