After a subtotal gastrectomy, the nurse should anticipate that nasogastric tube drainage will be what color for about 12 to 24 hours after surgery?
A. Dark brown
B. Bile green
C. Bright red
D. Cloudy white
Correct Answer: A. Dark brown
About 12 to 24 hours after a subtotal gastrectomy, gastric drainage is normally brown, which indicates digested blood. The aims of prophylactic drainage are to prevent repeated infection (for example by discharging remnant blood and preventing abscess formation), control possible leakage from the surgical seam (by drainage of the digestive closure, for example, a colonic anastomosis), and to provide a warning of potential complications.
Option B: Bile green is not expected during the first 12 to 24 hours after subtotal gastrectomy. Bile-colored (greenish) drainage is characteristic when the tube is in the duodenum. Measure and record the amount of drainage. Dispose of measured drainage by flushing into the hopper or toilet.
Option C: Drainage during the first 6 to 12 hours contains some bright red blood, but large amounts of blood or excessively bloody drainage should be reported to the physician promptly. In gastrointestinal drainage, blood varies in color–it may be dark red when fresh, dark brownish-red, or in brown particles (“coffee ground drainage”) if it has been partially digested.
Option D: Cloudy, pale-yellowish drainage is characteristic when the tube is in the stomach. However, this is not expected within 12 to 24 hours. Measure the contents and empty the drainage bottle at the hours ordered by the physician, when the drainage bottle is two-thirds full or when suction is discontinued.
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