During a bolus feeding, the patient complains of vomiting and abdominal cramping but remains tachycardic. The best action is to:

• A. Increase the bolus size
• B. Reassess and continue after a break
• C. Discontinue the administration of the bolus feeding
• D. Administer antiemetic and resume at same rate

Answer: (C)

During enteral feeding, signs of intolerance such as vomiting, abdominal cramping, and tachycardia indicate the GI tract may not tolerate the current delivery. A bolus feed delivers a large volume quickly, which can overwhelm the stomach and increase the risk of aspiration or metabolic upset. Stopping the bolus feeding immediately removes the stimulus and allows a safe reassessment of the patient’s tolerance, volume status, and feeding plan. After stopping, you would evaluate symptoms, check residuals if applicable, assess abdominal findings, and confirm tube placement before deciding how to proceed—often resuming at a slower rate or switching to a continuous feed if tolerance is poor. Administering an antiemetic and continuing at the same rate doesn’t address the underlying intolerance and could worsen the situation, while increasing the bolus size would likely exacerbate symptoms. Reassessing and continuing after a break is less safe than stopping first because it may prolong exposure to an intolerant rate and raise risk of complications.