During a bolus feeding via nasogastric tube, the patient reports persistent abdominal distension and nausea. The nurse should do what?

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

Answer: (C)

Abdominal distension and nausea during a bolus enteral feeding indicate that the patient is not tolerating the feeding and there’s a risk of aspiration or further GI distress. The safest immediate action is to discontinue the bolus feeding to stop the influx of formula and allow the stomach to settle. After stopping, the nurse should assess for causes of intolerance—verify tube placement, check residual volume per protocol, and evaluate the abdomen for signs of distress or obstruction. Once symptoms resolve, the feeding can be reconsidered, often by resuming at a slower rate or switching to a continuous feeding method as ordered. Continuing at the same rate would worsen distension and risk complications, and pausing only to check placement or slowing without stopping may not address ongoing intolerance.