The nurse is preparing to administer an enteral tube feeding to a client via a nasogastric tube. Which nursing action should be completed first?

A. Isotonic solutions have a similar osmolarity to that of blood plasma, meaning they exert the same osmotic pressure as blood. This equilibrium prevents the movement of water across cell membranes, thereby maintaining cell volume and preventing cellular dehydration or swelling. Examples of isotonic solutions commonly used for intravenous fluid replacement include 0.9% saline (normal saline) and lactated Ringer's solution.
B. Hypotonic solutions have a lower osmolarity than blood plasma, meaning they exert less osmotic pressure than blood. When administered, hypotonic solutions cause water to move into cells, leading to cellular swelling. While hypotonic solutions can help hydrate cells and replenish intracellular fluid, they are not typically used for rapid volume replacement because they can exacerbate extracellular fluid deficits and cause complications such as cerebral edema or cardiovascular collapse.
C. Hypertonic solutions have a higher osmolarity than blood plasma, meaning they exert greater osmotic pressure than blood. When administered, hypertonic solutions cause water to move out of cells, leading to cellular shrinkage. Hypertonic solutions are often used to expand intravascular volume in cases of severe hypovolemia or shock, as they rapidly increase blood osmolarity and draw fluid from the interstitial space into the bloodstream. Examples of hypertonic solutions include 3% saline and 5% dextrose in 0.9% saline.
D. Hyperosmotic solutions have an elevated osmolarity compared to blood plasma, indicating a higher concentration of solutes. These solutions exert osmotic pressure that draws water out of cells, leading to cellular dehydration. While hyperosmotic solutions are not commonly used for rapid volume replacement due to their pot

A. One of the primary purposes of inserting an NG tube is to decompress the stomach by removing gastric contents. In the case of abdominal distention and severe vomiting, excess gas and fluid accumulation in the stomach can contribute to discomfort and further vomiting. The NG tube provides a way to suction out these contents, relieving pressure and reducing symptoms.
B. NG tubes can also be used to administer medications directly into the stomach. This route is particularly useful when a client is unable to take medications orally due to vomiting or other gastrointestinal issues. Medications can be crushed and dissolved in liquid form before being administered through the NG tube.
C. In some situations, such as when assessing for gastrointestinal bleeding or checking for tube placement, it may be necessary to determine the pH of gastric secretions. Gastric aspirate obtained through the NG tube can be tested for acidity, which can help confirm that the tube is correctly positioned in the stomach and provide information about the client's digestive function.
D. While NG tubes can be used to supply nutrients via tube feedings, this is not typically the primary rationale for their use in the acute situation described (abdominal distention and severe vomiting). However, in cases where a client is unable to tolerate oral intake due to their condition, tube feedings can be administered through the NG tube to provide essential nutrients and maintain nutritional status.