A nurse is administering a bolus feeding to a client via nasogastric tube. The client suddenly shows signs of coughing and dyspnea. What should the nurse do first?

• A. Discontinue the administration of the bolus feeding
• B. Continue feeding after a brief pause
• C. Elevate the head of bed and resume the bolus
• D. Flush the tube and continue

Answer: (A)

Preventing aspiration during enteral feeding is the priority. If a patient receiving a bolus via nasogastric tube suddenly coughs and has dyspnea, stop the infusion immediately. Discontinuing the bolus prevents more formula from entering the airway and gives time to assess the airway, adjust the patient’s position to aid breathing, and determine if suctioning or other interventions are needed. Continuing after a brief pause could still permit aspiration and worsen respiratory distress. Elevating the head and resuming, or flushing the tube and continuing, would not address the immediate airway risk and could push contents into the lungs. Stopping the feeding first is the safest, most appropriate action.