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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
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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