Nokea
A patients NG tube has become clogged after the nurse instilled a medication that was insufficiently crushed. The nurse has attempted to aspirate with a large-bore syringe, with no success. What should the nurse do next?
- A. Withdraw the NG tube 3 to 5 cm and reattempt aspiration.
- B. Attach a syringe filled with warm water and attempt an in-and-out motion of instilling and aspirating.
- C. Withdraw the NG tube slightly and attempt to dislodge by flicking the tube with the fingers.
- D. Remove the NG tube promptly and obtain an order for reinsertion from the primary care provider.
Correct Answer: B
Rationale: When a tube is first noted to be clogged, a 30- to 60-mL syringe should be attached to the end of the tube and any contents aspirated and discarded. Then the syringe should be filled with warm water, attached to the tube again, and a back-and-forth motion initiated to help loosen the clog. Removal is not warranted at this early stage and a flicking motion is not recommended. The tube should not be withdrawn, even a few centimeters.
You may also like to solve these questions
A nurse is caring for a patient with a subclavian central line who is receiving parenteral nutrition (PN). In preparing a care plan for this patient, what nursing diagnosis should the nurse prioritize?
- A. Risk for Activity Intolerance Related to the Presence of a Subclavian Catheter
- B. Risk for Infection Related to the Presence of a Subclavian Catheter
- C. Risk for Functional Urinary Incontinence Related to the Presence of a Subclavian Catheter
- D. Risk for Sleep Deprivation Related to the presence of a Subclavian Catheter
Correct Answer: B
Rationale: The high glucose content of PN solutions makes the solutions an ideal culture media for bacterial and fungal growth, and the central venous access devices provide a port of entry. Prevention of infection is consequently a high priority. The patient will experience some inconveniences with regard to toileting, activity, and sleep, but the infection risk is a priority over each of these.
The nurse is assessing placement of a nasogastric tube that the patient has had in place for 2 days. The tube is draining green aspirate. What is the nurses most appropriate action?
- A. Inform the physician that the tube may be in the patients pleural space.
- B. Withdraw the tube 2 to 4 cm.
- C. Leave the tube in its present position.
- D. Advance the tube up to 8 cm.
Correct Answer: C
Rationale: The patients aspirate is from the gastric area when the nurse observes that the color of the aspirate is green. Further confirmation of placement is necessary, but there is likely no need for repositioning. Pleural secretions are pale yellow.
A nurse is participating in a patients care conference and the team is deciding between parenteral nutrition (PN) and a total nutritional admixture (TNA). What advantages are associated with providing TNA rather than PN?
- A. TNA can be mixed by a certified registered nurse.
- B. TNA can be administered over 8 hours, while PN requires 24-hour administration.
- C. TNA is less costly than PN.
- D. TNA does not require the use of a micron filter.
Correct Answer: C
Rationale: TNA is mixed in one container and administered to the patient over a 24-hour period. A 1.5-micron filter is used with the TNA solution. Advantages of the TNA over PN include cost savings. Pharmacy staff must prepare both solutions.
A nurse is creating a care plan for a patient who is receiving parenteral nutrition. The patients care plan should include nursing actions relevant to what potential complications? Select all that apply.
- A. Dumping syndrome
- B. Clotted or displaced catheter
- C. Pneumothorax
- D. Hyperglycemia
- E. Line sepsis
Correct Answer: B,C,D,E
Rationale: Common complications of PN include a clotted or displaced catheter, pneumothorax, hyperglycemia, and infection from the venous access device (line sepsis). Dumping syndrome applies to enteral nutrition, not PN.
A patients health decline necessitates the use of total parenteral nutrition. The patient has questioned the need for insertion of a central venous catheter, expressing a preference for a normal IV. The nurse should know that peripheral administration of high-concentration PN formulas is contraindicated because of the risk for what complication?
- A. Chemical phlebitis
- B. Hyperglycemia
- C. Dumping syndrome
- D. Line sepsis
Correct Answer: A
Rationale: Formulations with dextrose concentrations of more than 10% should not be administered through peripheral veins because they irritate the intima (innermost walls) of small veins, causing chemical phlebitis. Hyperglycemia and line sepsis are risks with both peripheral and central administration of PN. PN is not associated with dumping syndrome.