A patient’s nasogastric tube has not drained for several hours and the abdomen is distended. What should the practical nurse do first?

• A. Irrigate the tube.
• B. Instill saline in the tube.
• C. Remove the tube.
• D. Notify the physician.

Answer: (A)

When an NG tube isn’t draining and the abdomen is distended, the first step is to restore the tube’s patency by flushing it with warm saline to clear a possible blockage. This simple, noninvasive maneuver can quickly relieve occlusion from secretions, clots, or a kink in the tube, allowing gastric contents to drain again and reducing the risk of further distension or aspiration. If drainage returns after irrigation, continue to monitor and manage per orders. If irrigation does not restore drainage, check for a kink or coil, reposition the tube if needed, and notify the physician for further guidance.