When a patient receiving bolus feeding via a nasogastric tube develops coughing during administration, what should the nurse do?

• A. Elevate the head of bed and finish
• B. Discontinue the administration of the bolus feeding
• C. Flush the tube and resume
• D. Switch to a continuous drip and monitor

Answer: (B)

Coughing during bolus feeding signals a high risk of aspiration or possible tube misplacement, so the priority is to protect the airway and stop the current feeding. Discontinuing the bolus feed immediately prevents additional formula from entering the airway and gives you a moment to assess the patient's breathing, verify tube placement, and decide on the safest next step. Elevating the head of the bed is helpful for reducing aspiration risk, but it doesn’t address the immediate need to stop the active bolus to prevent further entry of contents into the airway. Continuing the administration or attempting to resume after a brief flush could push contents toward the airway and worsen the situation. Switching to a continuous drip might be considered later, but it isn’t the correct immediate response to coughing during bolus administration.