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 A
Explanation
A. Brushing the client's teeth with a suction toothbrush every 12 hours is a key intervention to reduce the risk of ventilator-associated pneumonia (VAP). Oral hygiene helps to decrease the accumulation of bacteria in the mouth, which could potentially be aspirated into the lungs and cause infection. This should be done more frequently, often every 4–6 hours, to reduce bacterial colonization.
B. Providing humidity to the ventilator tubing is necessary to maintain adequate moisture and prevent airway dryness, but it does not directly reduce the risk of VAP. Oral care and head-of-bed positioning are more crucial in preventing infection.
C. The head of the client's bed should be kept elevated, not flat, to reduce the risk of aspiration, which can lead to VAP. Keeping the head of the bed at a 30–45 degree angle is recommended.
D. Turning the client every 4 hours is important for preventing pressure ulcers and promoting circulation but is not the most effective intervention for reducing the risk of VAP. Frequent oral care and appropriate positioning are more important.
Correct Answer is B
Explanation
A. Petroleum jelly should not be used on the nares with oxygen therapy, as it is flammable and could pose a fire hazard. Non-petroleum-based lubricants should be used if needed.
B. A humidifier should be attached to the flow meter when delivering oxygen at higher flow rates (such as 6 L/min) to prevent dryness and irritation of the mucous membranes in the nose and throat.
C. The nasal cannula should generally be kept on during meals to ensure continued oxygen therapy, unless it is uncomfortable or the client has other medical needs.
D. The oxygen tubing should be secured to the client’s body or clothing in a way that does not restrict movement or cause injury, but securing it to the bed sheet could lead to a potential tripping hazard or interfere with mobility.
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