NCLEX-PN® ExaminationSafety and Infection ControlHard
An LPN is preparing to administer medication to a client via a nasogastric (NG) tube. After checking the tube placement, the LPN notes resistance when attempting to flush the tube with water. What is the most appropriate initial action?
- ANotify the registered nurse (RN) or physician immediately.
- BApply forceful pressure to the syringe to clear the obstruction.
- CReposition the client and attempt to flush the tube again gently.
- DInstill a small amount of carbonated beverage into the tube.
Show answer & explanationAnswer & explanation
Correct answer: C. Reposition the client and attempt to flush the tube again gently.
Resistance during flushing suggests a potential obstruction. Repositioning the client (e.g., turning from side to side) can sometimes dislodge the obstruction. Attempting to flush gently again after repositioning is a safe and appropriate initial step before escalating to more invasive or risky interventions.
Why the other options are wrong
- A. While the RN or physician may need to be notified eventually, less invasive measures should be attempted first.
- B. Forceful pressure can cause tube perforation or push the obstruction further into the tube.
- D. Carbonated beverages are not recommended for clearing NG tube obstructions as they are ineffective and can introduce air into the stomach.
NG Tube Obstruction
A blockage within a nasogastric tube that prevents fluid or medication from passing through.
- Common causes include crushed medication residue, formula, or tube kinking.
- Initial interventions focus on gentle methods like repositioning and gentle flushing.
- Forceful flushing or unapproved solutions should be avoided to prevent complications.
Memory trick: NG Tube Stuck? Reposition, Then Gently Chuck!