After her gastrectomy, actress Sandra Newton asks the nurse when the nasogastric tube will be removed. The nurse responds ______________.

  1. "According to standard procedures only, it will be removed on the fourth postoperative day."
  2. "When bowel sounds are established and you have passed flatus or stool."
  3. "Thirty-six hours after the cessation of bloody drainage."
  4. "After two days of alternate clamping and unclamping of the tube."
Explanation

Answer: B - The nasogastric tube is removed after bowel sounds have been reestablished (generally around the third day) and after the client has passed flatus or stool. Choices A and C are incorrect because they do not include the return of bowel sounds. Before removal, the tube is frequently clamped for 2 to 4 hours - not 2 days (Choice D) - to test the client's tolerance. Gastric residue is measured after this period. If it is more than 100ml, the nasogastric tube is left in place. Likewise, if the client experiences any pain, nausea, vomiting, or distention during this period, the tube is left in. If no symptoms occur and there is minimal amount of gastric residue, the tube is removed.

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