During bolus feeding via nasogastric tube, a patient shows signs of regurgitation and decreased oxygen saturation. The nurse should:

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

Answer: (A)

During bolus feeding through a nasogastric tube, regurgitation with decreased oxygen saturation signals a real risk of aspiration and airway compromise. The top priority is to protect the airway and stop any further administration of the feeding that could be aspirated. Discontinue the bolus feeding immediately to prevent more volume from entering the stomach and reduce the chance of inhaling stomach contents. Once feeding is stopped, elevate the head of the bed to about 30 to 45 degrees, assess breathing and oxygenation, administer oxygen as ordered, and monitor the patient closely for signs of aspiration. If possible, suction secretions to clear the airway and reassess the situation with the healthcare team before considering any resumption of feeding. Verification of tube placement and any further actions should be addressed after the patient is stabilized and the immediate airway/breathing concerns have been managed.