A charge nurse observes a nurse administer intermittent tube feedings via an NG tube to a client. Which of the following actions should prompt the charge nurse to intervene?

A. The nurse administers the feeding through a syringe barrel by gravity: This is an acceptable method for intermittent NG feedings, as long as the rate is controlled to avoid rapid infusion. It uses gravity rather than force, which is considered safe. B. The nurse allows the client to rest in a supine position during feeding: Feeding a client in the supine position increases the risk of aspiration and reflux. The client should be kept in at least a semi-Fowler’s or upright position during and for 30–60 minutes after the feeding. C. The nurse irrigates the NG tube with tap water after feeding: Flushing the tube with tap water is appropriate if the local water supply is deemed safe. It prevents clogging and ensures that all formula clears the tubing, so this does not require intervention. D. The nurse initiates the feeding after aspirating 50 mL of gastric residual: A gastric residual volume of 50 mL is within acceptable limits, so proceeding with the feeding is appropriate. Most protocols allow feedings to continue if the residual is less than 200–500 mL, depending on facility policy.