A 23-year-old male was brought to the ED after attempting suicide by drinking motor oil. Which HCP order should be questioned?

• A. Initiate intravenous fluids with a 20-gauge angiocatheter
• B. Insert an indwelling urinary catheter with a urometer
• C. Place a nasogastric tube and perform gastric lavage
• D. Monitor the client's cardiac status on telemetry

Answer: (C)

Hydrocarbon ingestion, such as motor oil, carries a high risk of aspiration pneumonitis, so gastric decontamination with a nasogastric tube and lavage is not recommended. Inserting an NG tube and performing gastric lavage can force liquid hydrocarbons into the lungs, and hydrocarbons are poorly removable by lavage or charcoal. The potential harm outweighs any benefit, so this order should be questioned.

The focus in this situation is airway protection and supportive care. If the patient’s mental status is depressed or airway compromise is suspected, securing the airway is a priority. Beyond that, maintaining fluids for perfusion and monitoring outputs and vital signs is appropriate, which is why starting IV fluids and monitoring urine output or cardiac status are reasonable parts of stabilization.