Before requesting restraints for a client who repeatedly pulls an NG tube, which intervention should the nurse consider?

Explain restraints will be the next step.

Assist with toileting at frequent intervals.

Provide diversionary activities.

Diversionary activities work best here because they give the patient a meaningful focus and help redirect restless energy away from the NG tube. When someone is bored or anxious, they may pull at the tube to seek stimulation or relief. Providing engaging distractions—talking, music, television, simple games, or hands-on tasks—reduces that impulsive behavior without using restraints. This approach fits with using the least restrictive, noninvasive strategies first and preserves the patient’s autonomy while keeping the tube in place.

Explaining that restraints will be the next step isn’t appropriate as a first response, since it escalates care and limits the patient’s rights. Frequent toileting can help if bladder or bowel discomfort is a driver for agitation, but it doesn’t directly address the behavior of pulling the tube. Involving family is supportive and can help with reassurance, yet diversion specifically targets the behavior by occupying the patient’s attention. If diversion and comfort measures don’t reduce pulling, then reassessment and escalation to other strategies would be appropriate.

Involve the family in the client's care.

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