During bolus feeding, the patient reports chest discomfort and shortness of breath. The nurse should:

• A. Elevate the head of bed and finish the bolus
• B. Notify the physician and hold the feeding
• C. Increase the bolus rate
• D. Discontinue the administration of the bolus feeding

Answer: (D)

When a patient receiving a bolus enteral feeding reports chest discomfort and shortness of breath, the priority is to protect the airway and breathing. A bolus delivers formula rapidly, which raises the risk of aspiration or acute airway compromise if the patient cannot tolerate the feed. The safest immediate action is to discontinue the bolus feeding to stop further exposure and allow time to assess the patient’s respiratory status, monitor oximetry, and obtain urgent clinical evaluation. Elevating the head of the bed is helpful for reducing aspiration risk during feeds, but it does not address an ongoing acute event, and continuing the bolus or increasing its rate would worsen the situation. Discontinuing the feeding gives the patient a chance to stabilize and prompts further assessment and intervention as needed.