NCLEX-RNBasic Care and ComfortHard
A nurse is caring for a client receiving continuous enteral tube feeding through a nasogastric tube. To reduce the risk of aspiration, which action should the nurse implement?
- AKeep the client in a supine, flat position throughout the feeding to promote gastric emptying
- BPosition the client in a left lateral position with the head of bed flat during feeding
- CMaintain the head of bed elevated at 30-45 degrees during and for 30-60 minutes after feeding
- DElevate the head of bed only during feeding and immediately return to flat position afterward
Show answer & explanationAnswer & explanation
Correct answer: C. Maintain the head of bed elevated at 30-45 degrees during and for 30-60 minutes after feeding
Maintaining the head of bed at 30-45 degrees during feeding and for 30-60 minutes afterward reduces the risk of gastroesophageal reflux and aspiration of gastric contents. A flat or supine position increases reflux risk, and returning to flat immediately after feeding removes the protective effect before gastric emptying is complete.
Why the other options are wrong
- A. Flat positioning significantly increases aspiration risk during tube feeding.
- B. Left lateral flat positioning does not reduce reflux risk as effectively as elevation.
- D. Returning to flat immediately negates the protective effect needed after feeding.
Aspiration Prevention with Tube Feeding
To prevent aspiration during enteral feeding, the head of bed should be elevated 30-45 degrees during feeding and maintained for 30-60 minutes afterward.
- HOB 30-45 degrees is standard of care
- Maintain elevation after feeding stops, not just during
- Check gastric residual per protocol before/during feeds
Memory trick: "Up and stay up—30 to 45, for an hour after."