PN Adult Medical Surgical Practice Exam

In a client with an intestinal obstruction, what should the nurse do first if the client reports nausea?

1. Administer an antiemetic

2. Increase the IV fluid rate

3. Provide ice chips

4. Check for kinks in the NG tube

The correct answer is: Check for kinks in the NG tube

When a client with an intestinal obstruction reports nausea, the priority intervention is to check for kinks in the nasogastric (NG) tube. This is because an obstruction can lead to a build-up of gastric contents, which can increase nausea and discomfort. If the NG tube is functioning properly, it will help decompress the stomach by removing excess fluids and gases. Assessing the NG tube for kinks ensures that it is patent and effectively draining the contents of the stomach. A kink or blockage in the NG tube could prevent proper drainage, leading to increased pressure in the gastrointestinal (GI) tract, which can cause or exacerbate nausea. By ensuring the NG tube is open and operational, the nurse can alleviate the nausea in a more direct and effective manner. In contrast, while administering an antiemetic or providing ice chips might provide relief from nausea, addressing the underlying issue of potential obstruction and NG tube function takes precedence. Increasing the IV fluid rate is also important for hydration and may be relevant but does not directly address the immediate cause of the nausea in this scenario.