During bolus feeding via nasogastric tube, the client develops sudden shortness of breath and decreased oxygen saturation. The proper action is to:

• A. Continue the administration of the bolus feeding 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 with water and resume feeding

Answer: (C)

When a patient on bolus enteral feeding suddenly develops shortness of breath and a drop in oxygen saturation, the immediate concern is airway protection and stopping further aspiration. This presentation most strongly suggests aspiration of formula into the lungs, which can rapidly worsen respiratory status. Stopping the bolus feeding right away prevents more material from entering the airway and allows you to focus on breathing support.

After discontinuing the feed, assess and support respiration: monitor oxygen saturation, provide supplemental oxygen as ordered, and position the patient with the head of the bed elevated to ease breathing. Then recheck the patient’s status and, as soon as stability is achieved, verify tube placement and follow appropriate protocol before deciding whether to resume feeding—often at a slower rate or via a different method, per orders. Continuing at the same rate would risk further aspiration, and flushing then resuming could reintroduce material into the airway if the feeding route is still implicated.