Blocked NG tube

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I recently took an ATI test asking what to do in the case of a blocked NG tube when the nurse flushes it but, it is still blocked.

One answer was "Place client on left side" another "contact physician" another was "flush with NS"

I answered place client on left side because that's what my Wilkinson and Treas text says to do before contacting the Dr, but ATI testing says that is wrong and that the answer should be contact Dr.

Can anyone clear this up for me?

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Specializes in Complex pedi to LTC/SA & now a manager.

What is the logic in placing the client on left side for a blocked NGT that cannot be flushed?

If I flushed and still clogged placing on their side (ie head not elevated) can increase reflux/aspiration risk. Contact physician would either offer other options or an order to replace the tube. Saline should not be used to flush the NGT as it can alter electrolytes especially if the patient is NPO.

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What is the logic in placing the client on left side for a blocked NGT that cannot be flushed?

If I flushed and still clogged placing on their side (ie head not elevated) can increase reflux/aspiration risk. Contact physician would either offer other options or an order to replace the tube. Saline should not be used to flush the NGT as it can alter electrolytes especially if the patient is NPO.

Actually, flushing c water will alter electrolytes (think diffusion into capillary bed (water travels, saline stays)-> dilutional hyponatremia, among others), but saline won't.

But unless you have a Salem sump with a standing protocol to irrigate and reposition (and none of those things are true in this question), you don't screw with it without running it past the physician/provider first.

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Specializes in Complex pedi to LTC/SA & now a manager.

I was thinking of the free H2O flushes with my enteral feed patients. Thanks...

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Specializes in Emergency, Telemetry, Transplant.

Maybe I'm reading this wrong, but if the question states the NG tube was blocked when the nurse flushed, then how can the nurse flush it with NS?

Also, what do you gain by positioning the pt on his/her Lt. side? Even if their head is elevated, what would this gain for you? (I'm not asking as a criticism of you, the OP, I'm asking so that you can think this through.)

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Specializes in Complex pedi to LTC/SA & now a manager.
Maybe I'm reading this wrong, but if the question states the NG tube was blocked when the nurse flushed, then how can the nurse flush it with NS?

Also, what do you gain by positioning the pt on his/her Lt. side? Even if their head is elevated, what would this gain for you? (I'm not asking as a criticism of you, the OP, I'm asking so that you can think this through.)

NS won't likely bust a clog any quicker than water in my experience. So I understand your query...

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Specializes in Pedi.
Maybe I'm reading this wrong, but if the question states the NG tube was blocked when the nurse flushed, then how can the nurse flush it with NS?

Also, what do you gain by positioning the pt on his/her Lt. side? Even if their head is elevated, what would this gain for you? (I'm not asking as a criticism of you, the OP, I'm asking so that you can think this through.)

I had the same thought. The nurse cannot flush the tube, so how is she going to flush it with normal saline? Placing the client on his left side is not going to unclog the tube and I'm not sure what purpose that would serve. If I couldn't troubleshoot it, I'd call our Clinical Nurse Specialist or NP because none of the MDs I worked with in the hospital would know how to unclog an NG. But the answer to the question should be to call the MD.

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