A patient receiving a bolus feeding through an NG tube develops coughing and shortness of breath. The nurse should:

• A. Increase the bolus rate to finish quickly
• B. Reposition the patient and continue feeding
• C. Discontinue the administration of the bolus feeding
• D. Flush the tube and resume feeding

Answer: (C)

Protecting the airway during enteral feeding is the priority. Coughing and shortness of breath during a bolus through an NG tube indicate possible aspiration of the feeding into the lungs. The best action is to discontinue the bolus feeding immediately to stop any more material from entering the airway and to begin assessing the patient’s respiratory status. After stopping, position the patient upright, assess breathing and oxygenation, auscultate the lungs, and suction if secretions are present. Verify tube placement and notify the clinician for further orders; consider safer feeding options (such as continuous feeding or a post-pyloric tube) to reduce the risk of future aspiration. Resuming the bolus feeding right away or attempting to continue after repositioning would not address the potential airway compromise.