During the insertion of the nasogastric (NG) tube into a patient's left nares, the nurse meets strong resistance. What should the nurse have done to minimize the chance that this problem would occur?
a. Use a small-diameter tube.
b. Apply lubricant to the NG tube.
c. Instruct the patient to bear down.
d. Assess the patency of both nostrils.
D
To prevent tissue trauma and minimize patient discomfort during NG tube insertion, the nurse assesses the patency of both nares before insertion. This helps the nurse determine which naris is more patent and the best naris to use for the initial attempt. If the prescription calls for an NG tube, a soft, pliable gastric tube is an unsuitable substitute because a small tube does not allow aspiration of gastric contents. If the nares are obstructed, additional lubricant cannot overcome the obstruction and can cause significant patient trauma if the nurse attempts an insertion. The nurse avoids instructing the patient to bear down during NG tube insertion because the Valsalva maneuver engorges tissue and is more likely to impair passage of the tube.
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