NCLEX · Basic Care and Comfort

A client with a nasogastric tube for decompression after bowel obstruction asks why they can't eat or drink. What is the BEST explanation?

Correct answer

'The tube is removing gas and fluid that would otherwise build up behind the obstruction — eating or drinking would add more fluid and worsen the distension and pressure; we need to let the bowel rest and the obstruction resolve or prepare for surgery'

  1. A 'The doctor ordered it and it's the rules.'
  2. B 'The tube is removing gas and fluid that would otherwise build up behind the obstruction — eating or drinking would add more fluid and worsen the distension and pressure; we need to let the bowel rest and the obstruction resolve or prepare for surgery'
  3. C 'You'll be able to eat once the tube comes out tomorrow'
  4. D 'Eating could dislodge the tube'

Why this is the answer

NASOGASTRIC TUBE FOR GI DECOMPRESSION — patient education requires explaining the rationale clearly so the patient understands and complies. THE EXPLANATION: BOWEL OBSTRUCTION creates a mechanical blockage; intestinal secretions (gastric juice, bile, pancreatic secretions) continue to be produced at approximately 7-8 litres per day; these secretions accumulate proximal to (before) the obstruction; DISTENSION CONSEQUENCES: Progressive distension causes pain, nausea, vomiting; can reduce blood supply to the bowel wall (ischaemia); increases risk of perforation; THE NG TUBE: Drains the accumulating fluid and gas, relieving pressure; NPO STATUS: Eating or drinking adds fluid volume that the bowel can't pass through; worsens distension; increases pain; could complicate any upcoming surgical intervention. HOW TO EXPLAIN WELL: Use plain language; avoid jargon ('decompression' → 'removing gas and fluid that's building up'); tie the explanation to the patient's symptoms ('do you remember how much better you felt when the tube was placed and some of that pressure released? It's doing that continuously'); acknowledge that NPO is uncomfortable; explain what will indicate the obstruction is resolving (return of bowel sounds, passage of flatus, decreased NG output, reduction in distension). GOOD PATIENT EDUCATION: Explains the WHY, not just the what; tailored to the patient's level of understanding; addresses the patient's specific concern (in this case, wanting to eat/drink).
Source: NCLEX-RN Physiological Integrity — NG Tube Patient Education