In caring for an adult client receiving a bolus feeding through an NG tube, which action is the first step if signs of intolerance occur?

• A. Discontinue the administration of the bolus feeding
• B. Increase the rate
• C. Resume after repositioning
• D. Administer a prokinetic and continue

Answer: (A)

The key idea is that stopping the feeding is the immediate priority when a patient on an NG tube bolus feed shows intolerance. Bolus feeds deliver a large volume quickly, and signs like nausea, vomiting, abdominal distension, or unusual residuals signal the stomach can’t handle that rapid delivery. Halting the administration removes the ongoing source of excess volume, reducing the risk of further distension or aspiration and giving you a chance to evaluate the patient’s condition, check tube placement, reassess gastric residuals, and address any contributing factors.

After stopping, you’d typically flush the line to clear it and then monitor the patient or proceed with a different feeding approach (for example, a slower rate or continuous feeding) based on assessment. Increasing the rate or continuing after giving a prokinetic would not be appropriate as the first response to intolerance. Resuming after repositioning isn’t the immediate step because stopping the feeding takes precedence to prevent further complications while you assess the situation.