A postoperative client who is receiving continuous enteral feedings via a nasoenteric tube becomes dyspneic with a productive cough, and the nurse auscultates crackles and diminished breath sounds in lung bases. Which action is appropriate at this time?
A)Administer an inhaled bronchodilator
B)Check marked insertion depth of the tube
C)Request a prescription for a diuretic
D)Start the client on incentive spirometry

Question

A postoperative client who is receiving continuous enteral feedings via a nasoenteric tube becomes dyspneic with a productive cough, and the nurse auscultates crackles and diminished breath sounds in lung bases.  Which action is appropriate at this time?
A)Administer an inhaled bronchodilator
B)Check marked insertion depth of the tube
C)Request a prescription for a diuretic
D)Start the client on incentive spirometry

Quizplus · Accepted Answer

11ecbb05_cb2f_547f_b433_9742eb44cb01_MD0009_00 A nasoenteric tube is passed through the nares into the duodenum or jejunum when it is necessary to bypass the esophagus and stomach. Nasoenteric tubes have a decreased risk of aspiration compared with nasogastric tubes; however, a nasoenteric tube can become dislodged to the lungs, causing aspiration of enteral feedings. If a client with a feeding tube develops signs of aspiration pneumonia (diminished or adventitious lung sounds [eg, crackles, wheezing], dyspnea, productive cough), the feeding should be stopped immediately and tube placement checked (eg, measure insertion depth, obtain x-ray, assess aspirate pH) (Option B). Some facilities use capnography to determine placement; if a sensor detects exhaled CO₂ from the tube, it is in the client's airway and must be removed immediately. (Option A) An inhaled bronchodilator may be prescribed to treat aspiration pneumonia, but the priority is to stop the feeding and check tube placement to prevent additional aspiration. (Option C) Crackles may be heard with fluid overload, aspiration, or pneumonia. A diuretic would be appropriate if a client is experiencing pulmonary edema from fluid overload. If a client receiving enteral feedings develops signs of aspiration, the nurse should initially hold feedings and assess tube placement. (Option D) Incentive spirometry promotes expansion of the lungs and resolves atelectasis; however, the priority for this client is assessing for and preventing aspiration. Educational objective: Nasoenteric tubes can become dislodged, causing the tube to enter the stomach or lungs. Feedings should be stopped immediately and tube placement checked if the client develops signs of aspiration.

A Postoperative Client Who Is Receiving Continuous Enteral Feedings Via