The nurse is caring for a patient who has a Sengstaken-Blakemore tube in place.In caring for this patient,the nurse must

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It is crucial that the esophageal balloon be deflated before the gastric balloon is deflated,or else the entire tube will be displaced upward and occlude the airway.Correct positioning and traction are maintained by using an external traction source or a nasal cuff around the tube at the mouth or nose.External traction can be attached to a helmet or to the foot of the bed (not the side rail).Proper amounts of traction are essential because too little traction lets the balloon fall away from the gastric wall,resulting in insufficient pressure being placed on the bleeding vessels.Too much traction causes discomfort,gastric ulceration,or vomiting.

The Nurse Is Caring for a Patient Who Has a Sengstaken-Blakemore