What is the priority action for a nurse when a client with a bowel obstruction experiences nausea and vomiting?

In the context of a client with a bowel obstruction experiencing nausea and vomiting, the priority action is to insert a nasogastric tube. This intervention is crucial because a bowel obstruction can lead to fluid, gas, and gastric contents accumulating proximal to the obstruction, resulting in nausea and vomiting. The placement of a nasogastric tube helps relieve these symptoms by decompressing the stomach and allowing for the removal of excess secretions and air. It can also prevent complications such as aspiration and provides some symptomatic relief for the patient.

Administering Ringer's Lactate and starting an infusion of hyperalimentation fluids, while important in managing fluid and nutritional status, do not address the immediate complication of nausea and vomiting due to the obstruction. Assisting with ambulation, although beneficial for promoting peristalsis and bowel function in certain situations, is not effective in managing acute symptoms associated with a bowel obstruction, especially when nausea and vomiting are present. Thus, the priority action is clearly to insert a nasogastric tube for effective symptom relief and management of the condition.