Which of the following is the contraindication of gastric aspiration from NG tube?

AIIMS Delhi NO- 2019

Medical Surgical Nursing

Easy

Appeared in: AIIMS Delhi NO- 2019

Explanation

Esophageal varices are dilated, tortuous veins in the submucosa of the lower esophagus, most commonly caused by portal hypertension.
These veins have thin, fragile walls and are under high pressure.
The negative pressure created by gastric aspiration through an NG tube can easily cause these varices to rupture.
Rupture of esophageal varices leads to severe, often fatal, hemorrhage (bleeding).

Option A: Hypertension (high blood pressure) is a cardiovascular condition and not a direct contraindication for NG tube aspiration. While uncontrolled hypertension poses risks for many procedures, it does not inherently prevent gastric aspiration.
Option B: Diabetes is a metabolic disorder and does not pose a direct risk for the mechanical procedure of gastric aspiration. Patient's blood sugar levels need to be managed, but this does not contraindicate the use of an NG tube.
Option D: Severe dehydration is a condition that often necessitates fluid and electrolyte replacement. An NG tube can be a route for administering fluids, making it a potential treatment rather than a contraindication. Aspiration might be performed to empty the stomach before rehydration or feeding begins.

Clinical Relevance

Nursing practice connection: Knowing Contraindications for Nasogastric (NG) Tube Procedures helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A nurse must always review a patient's history for conditions like liver disease (a common cause of esophageal varices) before attempting NG tube insertion or aspiration. This is a critical patient safety check.
If a patient with a known history of liver cirrhosis or esophageal varices suddenly develops hematemesis (vomiting blood) after NG tube manipulation, the nurse must immediately stop the procedure, notify the physician, and prepare for emergency management of a variceal bleed.
What if? If a patient has a history of alcoholism and presents with abdominal distension and jaundice, the nurse should have a high index of suspicion for liver cirrhosis and potential esophageal varices, prompting extreme caution and consultation before any nasogastric procedure.

How to Approach the Question

First, identify the core procedure in the question: 'gastric aspiration from NG tube'.
Next, understand the key term: 'contraindication'. This means a condition or factor that serves as a reason to withhold a certain medical treatment due to the harm that it would cause the patient.
Evaluate each option based on its potential to be harmed by the procedure.
Consider Option A (Hypertension) and B (Diabetes): These are systemic diseases and are unlikely to be affected by a mechanical procedure in the esophagus/stomach.
Consider Option D (Severe dehydration): This is a state of fluid loss. An NG tube can be used to give fluids, so it's not a contraindication.
Consider Option C (Esophageal varices): Recall or deduce that these are fragile, swollen blood vessels in the esophagus. The suction from aspiration could easily cause them to tear and bleed. This presents a direct and severe risk, making it the most plausible contraindication.

Concept Tested & Keywords

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 761-763

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 pp. 52-54, 51-53