A nurse is preparing to administer a bolus enteral feeding to a client who has a gastrostomy tube. Which action should the nurse take first?

A nurse is preparing to administer a bolus enteral feeding to a client who has a gastrostomy tube. Which action should the nurse take first?

• A. Measure stomach contents
• B. Flush tube with water
• C. Elevate HOB
• D. Return gastric content into the gastrostomy tube

Answer: (C)

Positioning to protect the airway is the key idea. Elevating the head of the bed before administering a bolus enteral feeding places the patient in a safer position so that gravity helps keep stomach contents from refluxing up into the esophagus and potentially entering the lungs. This simple adjustment directly reduces the risk of aspiration during the feeding. After ensuring the patient is properly elevated, you would proceed with tube patency and content management (for example, flushing with water to clear the line and checking residuals if your protocol calls for it). These steps are important for a successful bolus but come after securing the safest position. Returning gastric contents during residual assessment is part of managing what was aspirated or measured, but it’s not the first action to take.

Positioning to protect the airway is the key idea. Elevating the head of the bed before administering a bolus enteral feeding places the patient in a safer position so that gravity helps keep stomach contents from refluxing up into the esophagus and potentially entering the lungs. This simple adjustment directly reduces the risk of aspiration during the feeding.

After ensuring the patient is properly elevated, you would proceed with tube patency and content management (for example, flushing with water to clear the line and checking residuals if your protocol calls for it). These steps are important for a successful bolus but come after securing the safest position. Returning gastric contents during residual assessment is part of managing what was aspirated or measured, but it’s not the first action to take.