What action should the nurse take if a client begins to cough and gag while inserting a nasogastric tube?

When a client coughs and gags during the insertion of a nasogastric tube, the most appropriate action is to pull the tube back slightly. This reaction is crucial because coughing and gagging can indicate that the tube is not in the correct position, potentially entering the trachea instead of the esophagus.

Pulling the tube back will help ensure that the tube is correctly positioned and not inadvertently placed in the airway, which could lead to serious complications such as aspiration or respiratory distress. It is important for the nurse to constantly monitor the client’s response during this procedure and make adjustments as necessary to maintain safety and comfort.

While instructing the client to breathe slowly or assisting them with sips of water may support comfort, these actions do not directly address the potential misplacement of the tube and do not provide immediate resolution to the client's coughing and gagging. Similarly, continuing to advance the tube despite these symptoms would be inappropriate and could escalate the risk of complications.