A 22-year-old male client recovering from a traumatic brain injury is on a rehabilitation unit with a percutaneous gastrostomy tube in place. He receives continuous formula at 65 mL/hr via feeding pump, and the last documented residual was 30 mL four hours ago. He is also progressing on a mechanical soft diet for lunch and dinner, taking small amounts by mouth with supervision due to mild swallow weakness noted by speech therapy. Vital signs are temperature 37.1°C, pulse 82, respirations 16, blood pressure 118/72 mmHg, oxygen saturation 97% on room air. The head of his bed is currently at 15 degrees. The LPN is preparing to administer the next scheduled bolus of formula through the gastrostomy tube. What should the LPN do first?
- Raise the head of the bed and confirm tube placement and residual before feeding.
- Begin the bolus feeding now to stay on schedule with the pump timer.
- Offer him his mechanical soft diet tray at the bedside without further swallow screening.
- Change his diet order to clear liquids because he has a swallow weakness.