The practical nurse (PN) is providing instructions to the unlicensed assistive personnel (UAP) preparing to give a total bed bath to an immobile client who has continuous feeding via a gastrostomy tube (GT). Which instruction is most important for the PN to emphasize?

The correct answer is Choice C. Choice A rationale: While it is important for the UAP to report any drainage observed around the GT insertion site, this is not the most important instruction. Drainage could indicate infection or dislodgement of the tube, both of which would require medical intervention. However, the risk of aspiration pneumonia, which can be life-threatening, is higher if the head of the bed is not raised during feeding. Choice B rationale: Using plenty of pillows to position the client on the side after bathing can contribute to the client’s comfort and safety. However, this is not as critical as preventing aspiration during tube feeding. Aspiration can lead to serious complications such as pneumonia. Choice C rationale: Keeping the head of the bed raised while the tube feeding is infusing is the most important instruction. This position helps prevent aspiration, which can lead to pneumonia, a potentially life-threatening condition. When a person is lying flat, there is a higher risk that the tube feeding formula will enter the lungs. Choice D rationale: Raising the entire bed while bathing the client can help reduce back strain for the UAP. While this is an important consideration for the UAP’s comfort and occupational safety, it is not as critical as the safety of the client receiving the tube feeding.