Gastrointestinal System Disorders Q 48 - Gyan Darpan : Learning Portal
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Saturday, 16 April 2022

Gastrointestinal System Disorders Q 48

After a subtotal gastrectomy, care of the client’s nasogastric tube and drainage system should include which of the following nursing interventions?
    A. Irrigate the tube with 30 ml of sterile water every hour if needed.
    B. Reposition the tube if it is not draining well.
    C. Monitor the client for N/V, and abdominal distention.
    D. Turn the machine to high suction if the drainage is sluggish on low suction.

Correct Answer: C. Monitor the client for N/V, and abdominal distention.

Nausea, vomiting, or abdominal distention indicated that gas and secretions are accumulating within the gastric pouch due to impaired peristalsis or edema at the operative site and may indicate that the drainage system is not working properly. Assess the comfort of the client. Check for presence of nausea and vomiting, feeling of fullness, or pain. May indicate incorrect operation of NG suction or blockage in the tube.

Option A: Saline solution is used to irrigate nasogastric tubes. Hypotonic solutions such as water increase electrolyte loss. In addition, a physician’s order is needed to irrigate the NG tube, because this procedure could disrupt the suture line. Irrigations are recorded as intake. Drainage from the NG tube is measured as output every 8 hours. If drainage is copious, more frequent emptying of the collection container will be necessary. Documentation provides an accurate record of the client’s response to NG drainage.
Option B: After gastric surgery, only the surgeon repositions the NG tube because of the danger of rupturing or dislodging the suture line. Always verify if the NG tube placed is in the stomach by aspirating a small amount of stomach contents. An X-ray study is the best way to verify placement.
Option D: The amount of suction varies with the type of tube used and is ordered by the physician. High suction may create too much tension on the gastric suture line. Inspect suction apparatus. Check that setting is correct for the type of suction (continuous or intermittent), range of suction (low, medium, high), and that movement of drainage through the tubing is present.

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