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Administer the next feeding only if there is less than 25 mL of residual volume from the previous feeding: A 25 mL cutoff is unrealistically low. Traditional thresholds for holding feedings have been much higher.

Place client in the left lateral position: The safest position for enteral feeding to reduce aspiration is upright (high-Fowler’s) or at least a 30°-45° elevated head of bed.

Administer feeding directly from the refrigerator: Cold formula can cause cramping and poor tolerance; feeding solutions should be warmed to room temperature before administration.

Switch to a low-carbohydrate diet: Low-carbohydrate diets can produce short-term weight loss for some, but they are not universally superior and may be hard to maintain; the healthier recommended approach is balanced calorie reduction plus activity.

Keep a list of my forbidden foods on hand at all times: Strictly forbidding foods can promote guilt, bingeing, and an unhealthy relationship with food. A flexible, portion-controlled approach and behavior strategies are preferable.

Buy more organic and less processed foods: Choosing less-processed whole foods can help, but “organic” alone does not guarantee lower calories nor ensure weight loss; portion control and overall caloric balance matter most.

The esophagus is the passageway from the throat to the stomach. If a feeding tube tip remains here, formula could easily reflux into the airway and cause aspiration.

Feeding tubes are not advanced into the large intestine. The large bowel’s function is fluid absorption and stool formation, not nutrient absorption.

In some cases, feeding tubes are advanced past the stomach into the duodenum or jejunum, especially for patients at high risk of aspiration (e.g., impaired gastric emptying, severe reflux). While this is appropriate, it requires specialized placement.

Suction her mouth and throat: May be needed if secretions or visible food are present and the patient cannot clear them, but suctioning is secondary to first stopping the feed and assessing the airway/level of obstruction.

Turn her on her side: Turning to the side helps drain secretions and reduces risk of aspiration into the lungs (useful after stopping the feed), but it is not the first immediate action.

Put on oxygen at 2 L nasal cannula: Oxygen can help if the patient becomes hypoxic, but oxygen does not remove an obstruction. Do not delay airway clearance to apply oxygen.

Have the patient cough vigorously when tubing is disconnected: Coughing can transiently raise intrathoracic pressure but is uncontrolled and may dislodge lines or cause complications.

Have the patient take a deep breath and hold it: Holding a deep breath raises intrathoracic pressure somewhat, but a true Valsalva (forced expiration against a closed glottis or “bear down”) is more effective.

Place patient in supine position with head of bed elevated 90 degrees: Head-up positioning lowers central venous pressure and increases the risk of air being entrained.

Assess bowel sounds: Reasonable if you suspect intolerance, but with a GRV of 125 mL (which is below common stop thresholds), immediate assessment of bowel sounds is not the priority action.

Raise the head of the bed to at least 45 degrees: Always keep the HOB elevated during enteral feeding to reduce aspiration risk; if not already elevated this is important, but it is not the priority response to a normal GRV of 125 mL.

Hold the feeding until you talk to the primary care provider: Not necessary for this residual value and may interrupt nutrition unnecessarily; hold-and-report is usually reserved for higher residuals or signs of intolerance.

Teaching the patient about the need for enteral feeding: Teaching requires professional nursing knowledge, critical thinking, and individualized instruction. Cannot be delegated to AP.

Administering enteral feeding bolus after tube placement has been verified: Feeding via tube involves risk of aspiration and requires assessment and verification skills, which cannot be delegated.

Evaluating the patient’s tolerance of the enteral feeding: Evaluation is part of the nursing process (assessment and judgment) and cannot be delegated to AP.

Fastening tube to the gown with new tape: Appropriate and good practice to prevent tube dislodgement as long as the tube is secured without tension and the tape is applied correctly.

Monitoring the patient’s weight as ordered: Appropriate nursing activity; weight monitoring is part of routine assessment for nutritional status and tube-feeding effectiveness.

Ambulating patient with enteral feedings still infusing: Often acceptable if the feeding is on a pump, tubing is secured, and patient stability/transfer protocols are followed.

Administering pain medication after meals: Pain should be controlled before meals to improve comfort and willingness to eat. Giving it after meals does not promote appetite.

Scheduling his respiratory therapy before each meal: Treatments before meals may tire or stress the client, reducing appetite. They should ideally be scheduled after meals.

Reinforcing the importance of his eating exactly what is delivered to him: Strict enforcement can create resistance and does not address appetite stimulation. Flexibility is more effective.

Apple juice and bouillon: These are clear liquids, not full liquids.

Water ice and ginger ale: These are also clear liquids; not sufficient for a full liquid diet.

Puréed beef and cream of broccoli soup: Puréed meat is considered mechanical soft or blenderized diet, not full liquid. Cream soup is acceptable, but puréed meat is not.

Gastrostomy tube: A gastrostomy tube delivers nutrition directly into the stomach through a surgically created opening. This is an example of enteral nutrition, not parenteral nutrition.

Nasogastric tube: A nasogastric tube passes through the nose into the stomach for feeding. This also represents enteral nutrition.

Jejunostomy tube: A jejunostomy tube delivers nutrition into the jejunum, another method of enteral feeding, not parenteral.

Obesity: Although alcohol is calorie-dense, most chronic alcoholics tend to suffer from malnutrition rather than obesity.

Dehydration: Alcohol has a diuretic effect, but the key nutritional issue is vitamin deficiency, not fluid imbalance.

Vitamin C deficiency: Less commonly associated with alcoholism compared to Vitamin B deficiencies.

Duodenal ulcers: NG feeding does not prevent ulcer formation. Ulcers are primarily linked to H. pylori infection, NSAID use, or acid imbalance.

Hyperglycemia: Hyperglycemia is more related to the composition of feedings and metabolic regulation, not the site of feeding.

Gastric ulcers: Feeding into the stomach does not specifically prevent gastric ulcers.