A nurse is caring for a client who is receiving enteral nutrition. Which of the following actions should the nurse take to reduce the client's risk of aspiration?

Nursing care for a client receiving enteral nutrition focuses on maintaining adequate nutrition while preventing complications such as aspiration, diarrhea, and abdominal distention. Enteral nutrition delivers nutrients directly into the stomach or small intestine and requires careful monitoring of gastric tolerance. One of the most serious risks is aspiration of gastric contents into the lungs, which can lead to pneumonia and respiratory compromise. Assessing gastric residual volume helps evaluate gastric emptying and reduces aspiration risk before feeding. Rationale: A. Checking gastric pH following bolus feedings is not a standard method for preventing aspiration. Gastric pH is typically used to verify initial feeding tube placement, not to assess feeding tolerance after administration. Post-feeding pH measurement does not reliably reduce aspiration risk. B. Instructing the client to lie in the supine position after bolus feedings increases the risk of aspiration because it allows gastric contents to reflux into the esophagus and potentially enter the airway. Clients receiving enteral nutrition should remain in a semi-Fowler’s or upright position during and after feedings to promote gastric emptying and reduce reflux. C. Adding blue dye to enteral feedings is not recommended due to safety concerns and lack of evidence supporting its effectiveness in preventing aspiration. Studies have shown that dye can be absorbed systemically and may lead to toxicity without improving detection of aspiration. This practice is no longer considered safe or standard. D. Measuring gastric residual volume prior to bolus feedings helps assess how well the stomach is emptying and whether it is safe to proceed with feeding. High residual volumes may indicate delayed gastric emptying, increasing the risk of reflux and aspiration. This assessment helps guide decisions about holding or adjusting enteral feeding to improve patient safety.