As the nasogastric tube is passed into the oropharynx, the client begins to gag and cough. What is the correct nursing action?

1. Remove the tube and attempt reinsertion.
2. Give the client a few sips of water.
3. Use firm pressure to pass the tube through the glottis.
4. Have the client tilt the head back to open the passage.


Correct Answer: 2
Rationale 1: This is a common response to the presence of a tube in the oropharynx, so removal of the tube is not necessary.
Rationale 2: Swallowing ice or water may help calm the gag reflex and also facilitate the "swallowing" of the tube.
Rationale 3: The nurse should not use pressure to pass the tube.
Rationale 4: The client's head should be tilted forward at this point. Tilting the head back will open the airway, not the esophagus.

Nursing

You might also like to view...

A nurse is working with a student on the acute care psychiatric unit. The student asks the nurse why it is important to assess clients' values when there are many other more important issues to attend to. The nurse's reply should emphasize that:

A) Values regarding health are common across many cultures. B) Values form the scientific rationale for health behaviors. C) Clients' values should be congruent with nurses' values. D) Health behaviors are strongly influenced by personal values.

Nursing

A nurse is assisting a neurosurgeon who is monitoring a client's intracranial pressure

(ICP) in the intensive care unit. What measure is most critical in monitoring the client's intracranial pressure? A) Monitor and document the client's vital and neurologic signs B) Stop immediately if there is a break in the ICP monitoring system C) Avoid moving the client's head up or down without physician orders D) Observe the client's general appearance as well as mobility level

Nursing

A threshold of 90% is identified for an outcome indicator in the quality improvement program. Which of the following situations indicates a need for further review of the quality improvement plan?

1. The waiting time for clinic appointments has decreased 96%. 2. Clients with renal dialysis expressed a 95% satisfaction with their care. 3. In 93% of clients, subjective expressions of postoperative pain have decreased. 4. Wound infections are evident in 92% of clients after care of their IV access ports.

Nursing

The clinical paradigm in psychodynamic approach attempts to discover how leaders and organizations really work

a. True b. False

Nursing