NG to suction= risk for aspiration?

Episteme · Apr 23, 2014

The NG tube and suction per se? No, so much. Are you trying to find an appropriate nursing diagnosis?

I think a lot of nursing students look at the patient and focus on the most immediately obvious thing and then try to "pick the right NANDA".

You have a patient on TPN, with gastric decompression going on. Have you thought about looking for a REAL problem (not "risk for").

So... why does your patient have an NG hooked to suction? What's going on with his/her gut? Have you examined the abdomen and auscultated it? Is your patient having pain (a paralytic ileus can be really uncomfortable). How much stuff are you pulling out? Enough to drain off valuable electrolytes? (especially potassium.) Say, have you looked at your patient's laboratory stuff... like his/her basic metabolic panel.

What does the NG aspirate look like? Any blood in it? Is your patient getting IV PPI's to prevent gastric erosion?

Wow... your patient's life is totally dependent upon our (health care team's) actions. Are you absolutely certain we are giving enough fluid replacement to cover what the patient is losing and what exactly are we giving? Say, what was your patient's intake and output anyway? Is anyone getting daily weights on this patient? What's his urine output?

What does your patient say about the experience of having a tube down his nose through the back of his throat and into his stomach?

There is just a ton of things you have to explore before you even THINK about your diagnosis.

RNstudent5781 · Apr 23, 2014

The NG tube and suction per se? No, so much. Are you trying to find an appropriate nursing diagnosis?
I think a lot of nursing students look at the patient and focus on the most immediately obvious thing and then try to "pick the right NANDA".
You have a patient on TPN, with gastric decompression going on. Have you thought about looking for a REAL problem (not "risk for").
So... why does your patient have an NG hooked to suction? What's going on with his/her gut? Have you examined the abdomen and auscultated it? Is your patient having pain (a paralytic ileus can be really uncomfortable). How much stuff are you pulling out? Enough to drain off valuable electrolytes? (especially potassium.) Say, have you looked at your patient's laboratory stuff... like his/her basic metabolic panel.
What does the NG aspirate look like? Any blood in it? Is your patient getting IV PPI's to prevent gastric erosion?
Wow... your patient's life is totally dependent upon our (health care team's) actions. Are you absolutely certain we are giving enough fluid replacement to cover what the patient is losing and what exactly are we giving? Say, what was your patient's intake and output anyway? Is anyone getting daily weights on this patient? What's his urine output?
What does your patient say about the experience of having a tube down his nose through the back of his throat and into his stomach?
There is just a ton of things you have to explore before you even THINK about your diagnosis.

We have to make a complete list of all diagnoses. I was contemplating adding a risk for aspiration since the NG was in place but unsure due to it being on suction.

Esme12, ASN, BSN, RN · Apr 23, 2014

Welcome!

What semester are you? What care plan resource so you have? It is impossible to tell you if this applies to your patient without an assessment...of the patient. Just because someone has an NGT doesn't mean they have trouble swallowing. Just like Episteme said....You have to ask your self....Why does the patient have this? What about their disease process requires them to have this medical intervention? What is this treatment providing for this patient? What are the risks associated to the patient for this medical intervention? Has it helped?

SO MANY STUDENTS fall into this trap...they know they need X amount of nursing diagnosis and they shouldn't use one they have used before. They go straight to the NANDA list and think "Hey I like the sound of that one" and then try to fit the patient into it.....which is exactly the opposite of what you should be doing.

Care plans are all about the assessment.

Tell us about yours so we can help.

Daytonite:

critical thinking flow sheet for nursing students

student clinical report sheet for one patient

Episteme · Apr 23, 2014

Very nice report sheet Esme. We have a similar one that we use in Critical Care. Students must have a systematic method that prompts them to make sufficient assessments in order to complete ANY assignment that involves thinking about a patient.

nurseprnRN, BSN, RN · Apr 23, 2014

We have to make a complete list of all diagnoses. I was contemplating adding a risk for aspiration since the NG was in place but unsure due to it being on suction.

Based on what? What's your evidence on how an NG tube per se (of itself) would increase chances of aspiration? Or do you think there's an increased risk of aspiration related to the reason the NG tube is there in the first place? Or are you just making a WAG? (wild-donkeycousin guess). HINT: When you read the list of risk factors for aspiration in the the NANDA-I 2012-2014, did you see "presence of nasogastric tube" on the list? (Another plea: Get the book.)

How do you make a "complete list of nursing diagnoses" without a good assessment? Surely you aren't thinking about just getting the list of the famous 217 NANDA-I nursing diagnoses and just pulling off the ones that sound kinda OK, are you? Think: evidence-based practice. This is what we're talking about when we say, "What's your assessment?" Where's your evidence?