A nurse is caring for an older adult patient who has had surgery for an intestinal obstruction and has an NG tube to wall suction. Which of the following interventions should the nurse include in the patient's postoperative plan of care? (Select all that apply)

Choice A rationale Postoperative patients, especially those with NG tubes and abdominal surgery, are at risk for atelectasis and pneumonia. Using an incentive spirometer every two hours while awake helps to promote lung expansion, clear secretions, and prevent respiratory complications by encouraging deep breathing. Choice B rationale To assess for peristalsis, the nurse must listen for bowel sounds. The continuous noise from the wall suction will obscure the bowel sounds, making an accurate assessment impossible. Therefore, the nurse must temporarily clamp or turn off the suction to auscultate the abdomen for bowel sounds. Choice C rationale Intestinal obstruction surgery and the presence of an NG tube can lead to immobility and venous stasis, increasing the risk for deep vein thrombosis (DVT) and pulmonary embolism (PE). Sequential compression devices promote venous return and are a critical intervention for DVT prophylaxis. Choice D rationale Repositioning the patient from side to side every two hours helps to prevent skin breakdown and pressure ulcers, which are risks for all bedridden patients. It also aids in promoting lung expansion and prevents atelectasis by allowing for better ventilation and perfusion in different lung areas. Choice E rationale The NG tube can become clogged with gastric contents, preventing adequate decompression. Irrigating the tube with 0.9% sodium chloride helps to maintain patency and ensure that the suction continues to remove stomach secretions, which is crucial for relieving pressure and preventing distention.