A male client undergoes total gastrectomy. Several hours after surgery, the nurse notes that the client’s nasogastric (NG) tube has stopped draining.. Notify the physician

A male client undergoes total gastrectomy. Several hours after surgery, the nurse notes that the client’s nasogastric (NG) tube has stopped draining. How should the nurse respond?

• a. Notify the physician
• b. Reposition the tube
• c. Irrigate the tube
• d. Increase the suction level

Answer A.

An NG tube that fails to drain during the postoperative period should be reported to the physician immediately. It may be clogged, which could increase pressure on the suture site because fluid isn’t draining adequately. Repositioning or irrigating an NG tube in a client who has undergone gastric surgery can disrupt the anastomosis. Increasing the level of suction may cause trauma to GI mucosa or the suture line.

The most appropriate response for the nurse in this situation is a. Notify the physician.

Here's why:

A sudden cessation of drainage from an NG tube after surgery can be a serious sign of complications such as:

- Tube obstruction:

The tube may be blocked by food debris, medication residue, or blood clots.

- Dislodgement:

The tube may have become dislodged from its position in the stomach.

- Anastomotic leak:

This is a serious complication where the surgical join between the esophagus and the remaining intestinal tract leaks, leading to leakage of stomach contents into the abdominal cavity.

Assessing and addressing the cause of the stopped drainage requires medical expertise and intervention. Therefore, notifying the physician immediately is the safest and most responsible course of action.

While the other options may be considered depending on the physician's instruction, they should not be undertaken without their knowledge and approval:

b. Repositioning the tube:

This may be attempted if the physician suspects dislodgement, but it should only be done with proper training and technique to avoid further complications.

c. Irrigating the tube:

This may be helpful if the physician suspects blockage, but it should only be performed with the appropriate solution and technique to avoid introducing air or damaging the tube.

d. Increasing the suction level:

This may be helpful in some cases, but it should only be done with the physician's order and under close monitoring as excessive suction can damage the stomach lining.

Therefore, in the given scenario, the nurse should prioritize notifying the physician for further evaluation and management of the stopped NG tube drainage.