NGTs, Wounds, Ostomies

A 68-year-old male patient is diagnosed with a small bowel obstruction. The nurse places an NGT and connects it to low intermittent suction per the doctor’s orders. The patient is concerned about the green and brown contents in the tubing and asks what the purpose of the NGT is. The nurse’s best response would be:

• “The NGT was placed for feedings since you are NPO.”

• “No need to worry about what’s in the tubing. That is supposed to be there.”

• “The suction is removing gastric contents since the NGT is in for decompression of the stomach while you have the obstruction.”

• “Good observation. That should not be there, so I will remove the NGT.”

The RN is training a novice nurse who received orders to place an NGT on their patient. In reviewing NGT placement before entering the room, the RN knows the novice nurse is aware of appropriate measuring for an NGT insertion if they state:

• "I will eye-ball about how long I think is the length from the patient’s nose to stomach."

• “The standard measurement is 32 inches in an adult, so I will mark that on the NGT before inserting.”

• "I will lubricate the tip of the NGT and insert until I meet resistance."

• “I will measure from the nose to earlobe to the tip of the xiphoid process and mark that on the NGT.”

The infectious disease doctor asks the RN to collect a culture of the patient’s abdominal wound because she is concerned for infection. To collect the culture, which of the following actions is most appropriate for the RN?

• Zig zag the culture swab in the wound bed immediately after removing the dressing

• Irrigate the wound and pat dry prior to culturing

• Wait until the next dressing change tomorrow to culture the wound

• Instill sterile water into the wound bed and allow wound to absorb fluid prior to culturing

A patient is admitted to the hospital with pneumonia and is being treated with IV antibiotics. The patient has an established colostomy that the nurse noted started putting out high volumes of liquid stool today. Based off the nurse’s knowledge of colostomies, the nurse should first…

• Notify the doctor about the stool consistency change

• Change the colostomy bag every hour

• Expect a prolapsed stoma

• Stop the IV antibiotics

When educating a patient with a new ileostomy, the nurse knows they will need to consider and educate on all of the following EXCEPT:

• The patient’s self-perception with an ostomy

• The expected output consistency

• How the ileostomy with inhibit urination

• How to empty the ostomy bag

A patient is providing teachback after the RN provided discharge instructions regarding dressing their colostomy. The RN knows the patient understands when they verbalize:

• “I will assess my stoma daily and some black discoloration is expected.”

• “I should measure my stoma with a 2 inch border for applying the colostomy bag.”

• “I will remeasure my stoma every time I empty the colostomy bag.”

• “I should measure my stoma as close as possible to the border for applying the colostomy bag.”