A hospitalized client who has an advance directive and healthcare power of attorney is receiving enteral nutrition through a nasogastric (NG) tube. The client vomits and appears to be choking. Which action should the nurse take?

A. Irrigate the nasogastric tube with water may be necessary if the tube is clogged, but it does not address the immediate concern of the client choking. The priority is ensuring the client’s airway is clear. B. Elevate the head of bed 45 degrees is a useful intervention for reducing aspiration risk, but it does not address the immediate need to clear the airway when the client is choking. Elevating the head of the bed could be helpful after the airway is cleared. C. Review the advanced directive document is important for understanding the client’s wishes, but the immediate priority is addressing the choking. The nurse should focus on clearing the airway first, then review the advanced directive as appropriate. D. Perform oropharyngeal suctioning is the most appropriate action. The client is vomiting and choking, which suggests a risk of airway obstruction. Oropharyngeal suctioning will help clear the airway and prevent aspiration, which is the priority in this situation.