Which client is at the highest risk for aspiration?

Considering the risk factors associated with aspiration, a client receiving continuous enteral feeding through a nasogastric (NG) tube is indeed at a higher risk for aspiration. This is because the continuous flow of liquid nutrition can easily lead to the risk of material entering the airway if not managed carefully.

In this situation, the position of the client is critically important. If they are not adequately positioned (ideally at an elevation of 30 to 45 degrees), there is a significant likelihood that the feeding could backflow and cause aspiration. Additionally, any potential regurgitation of the formula can increase the risk of aspiration, especially if the swallowing reflex is impaired.

While clients with dysphagia also face risks related to aspiration, feeding through an NG tube presents a continuous potential for aspiration, especially if protocols for safe administration are not strictly followed. In contrast, a client receiving oral medication or one positioned upright typically has lower risks of aspiration, provided they are able to swallow safely and maintain an appropriate posture during intake. Thus, among the options, the client receiving continuous enteral feeding has the highest associated risk for aspiration.