Question

A nurse is caring for four clients on a medical-surgical unit. Which of the following clients should the nurse assess first?

A) A client who has a nasogastric tube for decompression and the gastric aspirate is green with a pH of 5.3
B) A client who had an indwelling urinary catheter removed 5 hr ago and has not voided
C) A client who has COPD and the capillary refill time on both hands is 4 seconds
D) A client who has late-stage cirrhosis and whose breath has a fruity odor

Answer 1

The nurse should assess the client who has a nasogastric tube for decompression and the gastric aspirate is green with a pH of 5.3. This indicates a potentially serious condition called bile reflux.

Step-by-step explanation:

The nurse should assess the client who has a nasogastric tube for decompression and the gastric aspirate is green with a pH of 5.3. This indicates a potentially serious condition called bile reflux, which can cause bile to flow back into the stomach. Bile reflux can lead to complications such as gastritis and esophagitis. It is important for the nurse to assess this client first to prevent further complications and provide appropriate treatment.