A male client undergoes total gastrectomy. Several hours after surgery, the nurse notes that the client’s nasogastric (NG) tube has stopped draining. How should the nurse respond?
A. Notify the physician.
B. Reposition the tube.
C. Irrigate the tube.
D. Increase the suction level.
Correct Answer: A. Notify the physician
An NG tube that fails to drain during the postoperative period should be reported to the physician immediately. It may be clogged, which could increase pressure on the suture site because fluid isn’t draining adequately. Nasogastric decompression has been routinely used in most abdominal operations to prevent the consequences of postoperative ileus.
Option B: Repositioning an NG tube in a client who has undergone gastric surgery can disrupt the anastomosis. Routine use of nasogastric tubes after abdominal operations is intended to hasten the return of bowel function, prevent pulmonary complications, diminish the risk of anastomotic leakage, increase patient comfort and shorten hospital stay.
Option C: Irrigating an NG tube in a client who has undergone gastric surgery can disrupt the anastomosis. Most surgeons traditionally continue to use nasogastric decompression, believing that its use facilitates a better surgical field and reduces complications such as nausea, vomiting, aspiration, and anastomotic leakage caused by postoperative ileus.
Option D: Increasing the level of suction may cause trauma to GI mucosa or the suture line. The reason to perform such activity may be either therapeutic, as in patients with distention and vomiting from bowel obstruction, diagnostic, as in the case of gastrointestinal bleeding or peptic ulcer disease, or prophylactic, as in patients having major abdominal surgery.
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