mrs sachett was returned to the ward following a hemicolectomy. a large bore ngt was insitu. there has been no naso-gastric tube drainage for 2 hrs and mrs sachett is also complaining of nausea. using an analysis of the literature and knowledge of post-op care for patient post hemicolectomy respond to each of the following:
1. check the patency of the ngt by instillation of 20ml of air into the ngt and listen for the 'swooshing' of air over the stomach with a stethoscope.
2. ensure the ngt drainage bag is below the bed frame, then check the patency of the ngt first by aspiration with a toomey syringe and testing the aspirate with litmus paper or ph strips. as you would expect around 50ml of fluid to build up in the stomach every hour.
3. lie mrs sachett down as post op blood pressure would be low and this combined with the morphine may be making her dizzy. following the determination of ngt patency the patient can then be administered iv tropisetron or stemetil.
4. administer maxolon which is always the first anti-emetic mediation orders on the post-operative nausea an d vomiting protocol.