An adult client is prescribed a 250 mL intermittent enteral feeding formula via an established nasogastric tube. To minimize the risk of procedural complications, arrange the following nursing actions in the correct chronological sequence.
- 1Position the head of the bed to an elevation of at least 30 degrees.
- 2Aspirate gastric contents to verify correct tube placement.
- 3Check the gastric residual volume to assess feeding tolerance.
- 4Flush the feeding tube with 30 mL of purified water.
- 5Initiate the administration of the prescribed enteral formula.
Answer
The correct sequence is: position the head of the bed, verify tube placement, check gastric residual volume, flush the tube, and finally initiate the feeding.
Safe administration of enteral feedings requires a prioritized approach to minimize the risk of aspiration and misplacement complications. Elevating the head of the bed (at least 30 degrees) is the initial priority to physically protect the airway via gravity. Next, the nurse must verify the tube is in the stomach to ensure fluids will not be instilled into the lungs. Third, measuring the gastric residual volume evaluates the client's tolerance and prevents gastric overdistension. Fourth, flushing the tube maintains patency and clears the line. Finally, once all safety criteria are met, the feeding can be safely administered.
Step-by-Step Solution
Key Concept
Reduction of risk potential during enteral feeding relies on a strict sequence of airway protection, placement verification, tolerance assessment, and maintaining tube patency.