Medical Surgical Sodium Na+ #1

Question

A client with a nasogastric tube is prescribed irrigations once per shift. The client has a serum potassium level of 4.5 mEq/L and a sodium level of 132 mEq/L. Based on these laboratory findings, which solution should the nurse use to irrigate the nasogastric tube?

Answers

  1. Tap water
    • Rationale:

      This answer is not correct because tap water will further dilute the serum sodium level; therefore, it is not used for NGT irrigation. Due to electrolyte losses (e.g., sodium) that can occur as a result of NGT drainage, sodium chloride (i.e., normal saline) is the solution that is used for irrigation purposes.

  2. Sterile water
    • Rationale:

      This answer is not correct because sterile water will further dilute the serum sodium level; therefore, it is not used for NGT irrigation. Due to electrolyte losses (e.g., sodium) that can occur as a result of NGT drainage, sodium chloride (i.e., normal saline) is the solution that is used for irrigation purposes.

  3. Distilled water
    • Rationale:

      This answer is not correct because distilled water will further dilute the serum sodium level; therefore, it is not used for NGT irrigation. Due to electrolyte losses (e.g., sodium) that can occur as a result of NGT drainage, sodium chloride (i.e., normal saline) is the solution that is used for irrigation purposes.

  4. Sodium chloride
    • Rationale:

      This answer is correct because a sodium level of 132 mEq/L is low or the client is experiencing hyponatremia. Using sodium chloride to irrigate the nasogastric tube will help bring the serum sodium level to an acceptable level.

Overview

A nasogastric tube (NGT) is a tube that is passed through the nose and down through the nasopharynx and esophagus into the stomach. Due to electrolyte losses (e.g., sodium) that can occur as a result of NGT drainage, sodium chloride (i.e., normal saline) is the solution that is used for irrigation purposes.

Explanation

Learning Outcomes

For most clients who cannot attain an adequate oral intake from food, oral nutritional supplements, or who cannot eat and drink safely, they may be given prescribed nutrition via nasogastric tube feeding. The NGT is flushed, or irrigated at prescribed intervals to decrease the risk of the tube becoming clogged. Due to electrolyte losses (e.g., sodium) that can occur as a result of NGT drainage, sodium chloride (i.e., normal saline) is the solution that is used for irrigation purposes.

Test Taking Tip

Consider evidence-based practice guidelines regarding the care of a client with an NGT and the client’s currently laboratory findings to answer this question correctly.

Video Rationale