Nasogastric Tube Insertion: Assessment Considerations

QUESTION

A nurse is caring for a client who needs a nasogastric tube inserted. Which assessment finding would prohibit insertion of the tube?​ Basilar skull fracture​ Hypoactive bowel sounds​ Abdominal distention​ Platelets 200,000 ​

ANSWER

Nasogastric Tube Insertion: Assessment Considerations

Introduction

The insertion of a nasogastric tube is a common medical procedure used for various purposes, such as administering medications, providing nutrition, or relieving gastric distention. However, there are specific contraindications and assessment findings that should be considered before proceeding with the insertion to ensure the safety and well-being of the patient. In this essay, we will explore the assessment finding that would prohibit the insertion of a nasogastric tube among the options provided.

Assessment Findings and Contraindications

1. Basilar Skull Fracture

A basilar skull fracture is a severe head injury that can have life-threatening complications, including cerebrospinal fluid leakage and intracranial infections. Inserting a nasogastric tube in a patient with a basilar skull fracture is contraindicated due to the risk of further trauma to the fragile skull base and the potential for introducing infection into the central nervous system.

2. Hypoactive Bowel Sounds

Hypoactive bowel sounds, which indicate reduced or absent intestinal motility, may not necessarily prohibit the insertion of a nasogastric tube. In some cases, the tube may be inserted to decompress the stomach or provide enteral nutrition as part of the treatment plan.

3. Abdominal Distention

Abdominal distention, while potentially uncomfortable for the patient, is not typically a contraindication for nasogastric tube insertion. In fact, the presence of abdominal distention may be an indication for the insertion of a nasogastric tube to relieve gastric pressure and discomfort.

4. Platelets 200,000

A platelet count of 200,000 is within the normal range (usually ranging from 150,000 to 450,000 platelets per microliter of blood). This platelet count does not prohibit the insertion of a nasogastric tube. Platelet counts are primarily assessed to evaluate bleeding risk during invasive procedures, but this particular platelet count does not indicate a contraindication.

Conclusion

Among the assessment findings provided, the presence of a **basilar skull fracture** would prohibit the insertion of a nasogastric tube. This is due to the potential risks associated with introducing a foreign object into the nasal passages and throat, which could further damage the fragile skull base and increase the risk of infection in the central nervous system. It is crucial for healthcare providers to conduct thorough assessments and consider contraindications before performing any medical procedure to ensure patient safety and well-being.