For a client post-cerebral vascular accident with a nasogastric tube, what should a nurse monitor closely to prevent complications?

Rationale: A. While monitoring bowel movements is part of overall patient care, it is not the primary concern for preventing complications related to nasogastric (NG) tube feedings. Bowel movement frequency does not directly prevent serious feeding complications such as aspiration. B. IV fluids may be necessary for hydration or medication administration, but they are not directly related to preventing NG tube complications. Monitoring fluids alongside feedings does not address the risk of aspiration or tube misplacement. C. Assessing swallowing is important in post-stroke patients, especially for oral intake, but when a patient has an NG tube in place, swallowing ability is bypassed. The NG tube delivers nutrition directly to the stomach, so swallowing ability is less immediately relevant for NG feeding safety. D. Ensuring proper NG tube placement before each feeding is critical to prevent serious complications such as aspiration pneumonia, gastric perforation, or ineffective nutrition delivery. Nurses should verify tube position via aspiration of gastric contents, pH testing, or radiographic confirmation according to facility protocol. Proper placement is the most important preventive measure to ensure safe enteral feeding.