OSSSC Nursing Officer-2023
Medical Surgical Nursing
Medium
While giving NG tube feeding which of the following nursing actions prevents complications?
Appeared in: OSSSC Nursing Officer-2023
Explanation
- Positioning the patient with the head of the bed (HOB) elevated to at least 30-45 degrees (high Fowler's) is a primary safety measure during NG tube feeding.
- This upright position utilizes gravity to prevent the backflow (reflux) of stomach contents into the esophagus.
- Preventing reflux is the most effective way to reduce the risk of pulmonary aspiration, a severe and potentially fatal complication of enteral feeding.
- This position should be maintained for 30 to 60 minutes after the feeding to allow for initial gastric emptying.
Why Other Options Were Wrong
- Option A: The tube's placement must be verified before initiating feeding. Advancing it during a feed is unsafe as it could enter the trachea or cause mucosal injury.
- Option B: Flushing is correctly performed with water (15-30 mL) to ensure tube patency, not with air. Using an air bolus for auscultation to check placement is an outdated and unreliable method.
- Option D: For a double-lumen Salem sump tube, the air vent (blue pigtail) must always be kept open and above the stomach level. Plugging it negates its function, leading to a vacuum effect that can damage the gastric mucosa and cause reflux.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Prevention of complications during nasogastric (NG) tube feeding helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Aspiration pneumonia is a leading cause of morbidity and mortality in patients receiving enteral nutrition. Correct positioning is a simple yet critical nursing intervention to ensure patient safety.
- Nurses must always verify tube placement before each intermittent feeding or every 4-6 hours during continuous feeding, in addition to proper positioning.
- What if the patient cannot tolerate a high Fowler's position due to a spinal injury or other contraindication? The nurse should use a reverse Trendelenburg position, which elevates the head of the bed while keeping the patient's body straight, to achieve a similar gravity-assisted protective effect.
How to Approach the Question
- First, identify the core concept of the question: preventing complications associated with NG tube feeding.
- Recall the most significant and common complication of NG feeding, which is pulmonary aspiration.
- Analyze each option to determine its role in the NG feeding procedure and its impact on patient safety.
- Option A (advancing the tube) is related to insertion, not safe administration, and is dangerous during feeding.
- Option B (flushing with air) is an incorrect procedure; flushing is done with water.
- Option D (plugging the air vent) is a harmful action that can cause mucosal damage and reflux.
Concept Tested & Keywords
- Concept Tested: Prevention of complications during nasogastric (NG) tube feeding.
- Stem keywords: NG tube feeding, nursing actions, prevents complications
- Lead-in keywords: which of the following
- Negative lead-in flag: false
Question ID
QE55rtAsOx4jVn3sKGxp5X
Reference Book
E6 Nursing Fundamentals Taylor p. 523-525
E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 202-204
Practise the full OSSSC Nursing Officer-2023
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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