مريضة عمرها ٧٨ سنة بعد جلطة دماغية، على تغذية مستمرة بالأنبوب. وجدها الممرض مستلقية على ظهرها، وصارت تكح وتتنفس بسرعة. العلامات الحيوية: التنفس ٣٠، التشبع ٨٨٪، النبض ١١٢، الحرارة ٣٧٫٩. ما الإجراء الأول؟

A 78-year-old woman after a stroke receives continuous tube feeding. The nurse finds her lying flat, coughing and breathing fast. Vitals: RR 30, SpO2 88%, HR 112, T 37.9 °C. What is the first action?

1. Stop the feeding, raise the head of the bed and suction as needed
2. Check the gastric residual, then continue the feeding
3. Increase the feeding rate to make up the deficit quickly
4. Give water by mouth to clear secretions from the throat

Answer: A) Stop the feeding, raise the head of the bed and suction as needed. This suggests aspiration of feed. Stop the feeding, raise the head, suction, give oxygen and notify the provider. Keep the head of bed 30–45° throughout feeding.