Indication for nasogastric intubation?

Appeared in: KPSC Staff Nurse - 2017

Explanation

Paralytic ileus is a condition where intestinal peristalsis stops, leading to a buildup of gas and fluid.
Nasogastric (NG) intubation is performed to decompress the stomach and intestines by removing these accumulated contents.
This decompression relieves symptoms such as abdominal distention, nausea, and vomiting, and helps prevent aspiration.
The procedure is a key intervention for managing conditions involving the absence of peristalsis or obstruction of the GI tract.

Option A: This is an indication for using an NG tube for enteral feeding, not for decompression. The primary issue is impaired swallowing (dysphagia), requiring an alternative route for nutrition.
Option B: Routine use of NG tubes after abdominal surgery is no longer standard practice. It is used selectively, not as a blanket indication for all abdominal surgeries.
Option D: This is a symptom, not a diagnosis or a direct indication for NG intubation. The cause of the pain must be determined first.

Clinical Relevance

Nursing practice connection: Knowing Indications for Nasogastric (NG) Intubation helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A key nursing responsibility is to manage the NG tube, which includes ensuring its patency, monitoring the amount and character of drainage, and providing nasal and oral care to maintain patient comfort.
Nurses must assess for the return of bowel function (e.g., passing flatus, audible bowel sounds) before the NG tube can be clamped or removed.
What if? If a patient with an NG tube for decompression suddenly develops respiratory distress, the nurse's first action should be to check the tube's placement, as it may have migrated into the airway, which is a medical emergency.

How to Approach the Question

First, understand the question is asking for a primary reason (indication) to insert a nasogastric (NG) tube.
Recall the main purposes of NG intubation: decompression, feeding, lavage, and compression.
Analyze each option in the context of these purposes. 'Paralysis of face and throat' relates to feeding. 'Abdominal surgery' and 'Acute abdominal pain' are too general.
'Paralytic ileus' directly points to a condition requiring gastric decompression, which is a primary and common indication for NG intubation.
Differentiate between a direct indication (paralytic ileus) and related but less precise options (abdominal surgery, a symptom like pain).
Select the most specific and appropriate medical condition that necessitates NG tube placement for decompression.

Concept Tested & Keywords

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E6 Nursing Fundamentals Potter Perry 12e Part 6 p. 43-45

E6 Gynecology Williams p. 57-80

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 2 p. 139-141

Practise the full KPSC Staff Nurse - 2017

Attempt every question from this paper in a timed mock, then review the full solution for each one.