During bolus feeding through an NG tube, a misplacement is suspected after observing persistent coughing and a lack of gastric drainage. The nurse should:

• A. Discontinue the administration of the bolus feeding
• B. Reinsert the tube and continue
• C. Continue feeding after repositioning
• D. Notify the physician and proceed with the drip

Answer: (A)

Stopping the bolus feeding is the safest first step when misplacement is suspected. Persistent coughing and lack of gastric drainage strongly suggest the tube isn’t in the stomach and may be in the esophagus or airway; delivering a bolus into an incorrect location raises the risk of aspiration and lung injury. The priority is to halt the feed and verify the tube’s position before attempting any further administration. After stopping, assess placement with available methods (external tube markings, aspiration for contents and pH, and radiographic confirmation if needed) and obtain physician guidance as necessary before resuming feeding. Repositioning or continuing the feed without confirming correct placement could cause serious harm.