Before initiating an NG tube feeding, which actions are routinely performed?

• A. Check residual volume and flush with sterile water
• B. Start feeding immediately and then check residual
• C. Administer medications without placement check
• D. Elevate HOB without checking placement

Answer: (A)

Verifying placement and patency before feeding is the safety concept here. You want to confirm the tube is in the stomach and not in the esophagus or trachea, and you want to make sure the tube is clear so the feed can pass through properly. Checking residual volume helps gauge how well the stomach is emptying and guides whether to continue or hold feeding, while flushing with water clears the line and prevents clogging. Together, these steps reduce the risk of aspiration and misadministration.

Starting the feed without first confirming placement is unsafe because the tube could be misplaced, leading to feeding into the airway or esophagus. Administering medications without verifying placement is similarly unsafe, and elevating the head of the bed without checking placement does not ensure the tube is correctly positioned.