A patient receiving a bolus feeding via NG tube begins to exhibit signs of aspiration such as coughing and decreased breath sounds. The best action is to:

• A. Continue the administration at the same rate
• B. Pause the feeding to check the tube placement
• C. Slow the rate and reassess for tolerance
• D. Discontinue the administration of the bolus feeding

Answer: (D)

When signs of aspiration appear during enteral feeding, safety hinges on stopping the feeding immediately. A bolus feeding delivers a large volume quickly, which increases the chance that gastric contents can move into the airway if the patient’s airway reflexes aren’t protecting the lungs. So discontinuing the bolus feeding stops further material from entering the lungs and allows you to focus on the patient’s breathing and airway protection.

After stopping, elevate the head of the bed to reduce the risk of further aspiration, assess the patient’s respiratory status, and provide any needed airway support (such as suction or oxygen per protocol). Notify the clinician to determine the next steps, which may include evaluating tube placement, reassessing tolerance, and deciding whether to restart feeding at a slower rate or switch to a continuous method with closer monitoring.