What action should a nurse take when performing gastric lavage for a client with upper gastrointestinal bleeding?

When performing gastric lavage for a client with upper gastrointestinal bleeding, inserting a large-bore NG tube is the most appropriate action. This type of tube allows for the efficient removal of whatever contents are present in the stomach, such as blood, clots, or any other material that may hinder assessment and management of the bleeding. The large diameter of the tube facilitates the passage of larger volumes of fluid, ensuring effective and rapid lavage.

In cases of upper gastrointestinal bleeding, it is essential to clear the stomach contents to better visualize the source and extent of the bleeding and to prepare the client for possible interventions, like endoscopy, where clear access to the stomach lining is needed. Using an adequately sized tube is crucial in these scenarios, as a small-bore tube would be insufficient for rapid and effective lavage, potentially delaying treatment.

Other options do not support the primary goal of rapidly clearing the stomach to address or assess the bleeding. Administering activated charcoal, for instance, is typically contraindicated in cases of gastrointestinal bleeding, as it can complicate the clinical picture by obscuring the source of bleeding and creating a risk for aspiration if the client’s protective mechanisms are compromised. Initiating IV fluid resuscitation, although critical in managing fluid status in a bleeding patient