A patient receiving nasogastric (RT) feeding has just completed a feeding session. To prevent aspiration and ensure proper digestion, which position should be maintained?

1. A

   Supine position

2. B

   Fowler's position

3. C

   Prone position

4. D

   Lithotomy position

Appeared in: NORCET-7 Mains-2024

Explanation

Listen in Hindi

• Fowler's position involves elevating the head of the bed to at least 30-45 degrees.
• This upright posture utilizes gravity to prevent gastric contents from flowing back into the esophagus and potentially into the lungs (aspiration).
• This position also facilitates gastric emptying, which aids digestion and reduces feelings of fullness or bloating.
• It is a standard safety protocol to maintain this position for at least 30 to 60 minutes after completing a feeding session.

Why Other Options Were Wrong

• Option A: Lying flat in the supine position eliminates the protective effect of gravity, significantly increasing the risk of gastroesophageal reflux and aspiration of stomach contents into the lungs.
• Option C: Lying on the stomach (prone) increases intra-abdominal pressure, which can induce vomiting and is generally uncomfortable after a feeding.
• Option D: The lithotomy position is used for gynecological, rectal, or urological examinations and procedures. It has no therapeutic role in feeding or digestion.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Patient positioning for enteral feeding safety to guide bedside assessment, documentation, and the next nursing action.
• Proper positioning is a critical, non-invasive nursing intervention to prevent aspiration pneumonia, a common and potentially fatal complication of enteral feeding.
• Nurses must educate patients and their families on the importance of maintaining an upright position after feedings, especially in home care settings, to ensure patient safety.
• What if? If a patient is medically required to lie flat (e.g., due to a spinal injury), the nurse should advocate for a post-pyloric feeding tube (e.g., nasojejunal) which bypasses the stomach, or place the patient in a reverse Trendelenburg position, if tolerated, to reduce aspiration risk.

How to Approach the Question

• First, identify the core task in the question: determining the safest position for a patient after a nasogastric feeding.
• Next, recall the primary risk associated with NG feedings, which is the aspiration of stomach contents into the lungs.
• Apply the principle of gravity. An upright position helps keep stomach contents down, while a flat position allows them to travel back up the esophagus.
• Evaluate each option based on this principle: Fowler's (upright) is protective; Supine (flat) is risky; Prone and Lithotomy are inappropriate for this clinical goal.
• Select the option that uses gravity to enhance patient safety, which is Fowler's position.

Concept Tested & Keywords

• Concept Tested: Patient positioning for enteral feeding safety
• Stem keywords: nasogastric (RT) feeding, prevent aspiration, proper digestion, position
• Lead-in keywords: which position
• Clinical cues: post-feeding session
• Negative lead-in flag: false

Question ID

Q8jyTN3zsQbOtOkiw5eNyj

Copy ID

Reference Book

E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 203-205