Anna is 45 y.o. and has a bleeding ulcer. Despite multiple blood transfusions, her HGB is 7.5g/dl and HCT is 27%. Her doctor determines that surgical intervention is necessary and she undergoes partial gastrectomy. Postoperative nursing care includes:
A. Giving pain medication Q6H.
B. Flushing the NG tube with sterile water.
C. Positioning her in high Fowler’s position.
D. Keeping her NPO until the return of peristalsis.
Correct Answer: D. Keeping her NPO until the return of peristalsis.
After surgery, she remains NPO until peristaltic activity returns. This decreases the risk for abdominal distention and obstruction. Caution the patient to limit the intake of ice chips. Excessive intake of ice produces nausea and can wash out electrolytes via the NG tube.
Option A: Monitor tolerance to fluid and food intake, noting abdominal distension, reports of increased pain, cramping, nausea, and vomiting. Complications of paralytic ileus, obstruction, delayed gastric emptying, and gastric dilation may occur, possibly requiring reinsertion of the NG tube.
Option B: Maintain patency of NG tube. Notify the physician if the tube becomes dislodged. Provides rest for GI tract during the acute postoperative phase until the return of normal function. The physician or surgeon may need to reposition the tube endoscopically to prevent injury to the operative area.
Option C: Auscultate for resumption of bowel sounds and note passage of flatus. Peristalsis can be expected to return about the third postoperative day, signaling readiness to resume oral intake.
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