NG and sterile dressing change skills quiz Flashcards
Which action would minimize the risk for cross-contamination while cleansing an infected abdominal surgical wound?
Wearing sterile gloves to cleanse the wound.
Cleansing the wound with sterile water.
Using a new gauze pad for each stroke while cleansing the wound.
Blotting the incision with dry gauze.
Using a new gauze pad for each stroke minimizes the risk for cross-contamination by preventing contaminated gauze from introducing microorganisms into other areas of the wound.
When changing a patient’s surgical dressing 24 hours postoperatively, when would the nurse apply sterile gloves?
After removing the original dressing materials and performing hand hygiene a second time.
After performing hand hygiene at the start of the procedure.
Just before cleansing the wound with sterile water.
Before removing the inner dressing.
The nurse would wear clean gloves to remove the contaminated original dressing, and he or she would then perform hand hygiene again. Only then would the nurse apply sterile gloves.
What would the nurse do if a sterile solution splashed onto a sterile field and contaminated the field during a dressing change?
Complete the dressing change in a timely manner.
Reposition the receptacle closer to the edge of the sterile field.
Collect new supplies and prepare another sterile field.
Move the lip of the bottle closer to the receptacle when pouring the remaining liquid.
Any breach in sterile technique requires that a new sterile field be established.
When checking gastric aspirate from a nasogastric (NG) tube, the nurse assesses a pH of 7. What would the nurse do next?
Pull back on the tube
Anticipate a chest x-ray
Nothing, since this is an expected pH value
Advance the tube
Normal gastric pH is 5 or less. A pH greater than 7 could mean that the tube is in the small intestine or lung. The nurse must act on this finding and anticipate a chest x-ray. Doing nothing, advancing or pulling back the tube is not correct.
An infant has a nasogastric (NG) tube in place after surgery. The patient is going home and no longer needs the tube. Before removing the tube, what should the nurse do?
assess for a gag reflex
offer the patient a pacifier
measure the patient’s abdominal girth
occlude the tube by bending it.
Great idea. We don’t want to get those scrubs covered in gastric contents. Occluding the tube also helps prevent aspiration of the gastric contents into the lungs.
The nurse is assessing an infant who is receiving enteral nutrition through a nasogastric (NG) tube. During the assessment the infant starts coughing and vomiting thick liquid. What should the nurse first?
Suction the oropharynx
Place the patient at a 45 degree angle
Check the pH of the emesis
Assess the placement of the tube
When caring for an infant receiving enteral nutrition by way of a feeding tube, the nurse should be prepared to initiate suction at the bedside if the patient vomits. Once the risk for aspiration is minimized, the nurse can continue the problem-solving process by determining the residual gastric volume and verifying tube placement in accordance with the organization’s practice. Checking the pH of the patient’s emesis and elevating the head of the bed are not pertinent in this clinical scenario.
When changing the dressing on the knee of a patient with a pin-site wound, an increased volume of drainage from the site and on the dressing is observed. The pin site is edematous and painful to the touch. A red streak is traveling up the patient’s leg toward the groin. What do these signs and symptoms indicate?
A wound with a pocket.
An infected wound.
A nectrotic wound.
A healing wound.
Exudate volume that persists or suddenly increases may indicate a local infection or bacteria. Tissue surrounding the wound may be edematous in infected wounds, healing wounds, and wounds with necrotic tissue. When a red streak appears, the infection is spreading. The practitioner must be notified of this change immediately to decrease complications.
When educating the family of a child with an NG tube, how should the nurse describe the purpose of a nasogastric tube that is used to decompress the stomach (gastric decompression)?
This NG tube provides a mechanism to irrigate the child’s stomach
This NG tube provides routine nutrition to your child
This NG tube ensures the child’s stomach is empty and facilitates better breathing.
This NG tube provides a route for medication administration to your child
A gastric decompression tube is placed for removal of air or fluid from the stomach. Medications and nutrition are not administered through the NG tube during decompression when the primary function is evacuation of air or fluid from the stomach. Gastric decompression is not for irrigation.
What is the most important step the nurse can take to minimize the risk of tearing a sterile glove when applying it to the hands?
Keeping the fingernails trimmed and smoothly filed.
Drying the hands thoroughly before applying the gloves.
Selecting the proper glove size.
Using powdered sterile gloves.
Improper glove size is the leading cause of glove tears.
During the nursing assessment of a patient with an orogastric tube for gastric decompression, the nurse observes dry and irritated oral mucus membranes. Which piece of equipment will the nurse need to proceed with an intervention?
A glass of water
Nasal cannula
Oral swab
A blue pad to remove the NG tube
OG or NG tubes may cause mouth breathing, which may dry the mouth and increase the risk of mucosal breakdown and ulceration; therefore, frequent mouth care is required and the practitioner should be notified if the condition worsens. Replacing an OG tube with an NG tube does not solve the problem. The patient with a decompression tube is getting nothing by mouth because the goal is to keep the stomach decompressed. Oxygen administration is not indicated because this patient’s respiratory status is not compromised.
