During bolus feeding via nasogastric tube, the client reports chest tightness and shortness of breath. The best course of action is to:

• 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. Flush the tube and resume feeding

Answer: (C)

When a patient receiving enteral nutrition through an NG tube reports chest tightness and shortness of breath, this can signal aspiration of the feed into the lungs or an airway reaction. The priority action is to stop the source of potential harm immediately. Discontinue the bolus feeding right away to prevent further liquid from entering the airway and to allow prompt assessment of the patient’s breathing and comfort. After stopping, assess respiratory status, monitor vital signs, and notify the medical team as needed. Continuing the feed or only pausing it to check placement could allow more aspirated material to accumulate and worsen the situation, and flushing to resume would not address the risk. Stopping the feeding first is the safest initial step to protect the patient.