During bolus feeding via a nasogastric tube, the client begins to cough and shows signs of potential aspiration. What is the best next action?

• A. Discontinue the administration of the bolus feeding
• B. Continue the administration of the bolus feeding at the same rate
• C. Slow the administration to half the rate and reassess
• D. Flush the tube with water and resume feeding

Answer: (A)

Stopping the bolus feeding immediately is essential when coughing and signs of potential aspiration appear. This reaction indicates material may have entered the airway, and continuing or slowing the feed could allow more contents to be inhaled, increasing the risk of aspiration pneumonia. Flushing and resuming, or continuing at the same or a slower rate, doesn’t address the airway safety issue and could worsen exposure of the lungs to gastric contents. By discontinuing, you protect the airway, allow time to reassess breathing, and prevent further risk. After stopping, address the airway: assess respiration, place the patient in an elevated position to help drainage and breathing, suction if needed, monitor oxygen, and notify the healthcare team. Once the patient is stabilized, you can reassess feeding plans with the provider.