Patient tolerance of the volume and type of formula must be monitored daily (Boullata et al., 2017; McClave, Taylor, et al., 2016). Criteria to consider when evaluating patient feeding tolerance include:

• Absence of nausea, vomiting
• Absence of diarrhea and constipation
• Absence of abdominal pain and feelings of fullness
• Absence of distention
• Achievement of target goal nutrition administration
• Presence of bowel sounds within normal limits

*Gastric residual volume (GRV) is not a suitable parameter to determine feeding intolerance and has been shown to be a poor marker of true gastric volume, gastric emptying, risk of aspiration, pneumonia, and poor outcomes (Hartwell et al., 2018; McClave, DiBaise, et al., 2016; McClave, Taylor, et al., 2016; Pars & Çavus¸og˘lu, 2019). Some evidence for practice suggests measurement of GRV may only be necessary during initiation and advancement of enteral nutrition (EN) (Roveron et al., 2018; Singer et al., 2019). If GRV checks are part of facility policy and procedure, automatic cessation of EN should be avoided for GRVs ;500 mL in the absence of other signs of intolerance (Boullata et al., 2017; McClave, Taylor, et al., 2016; Roveron et al., 2018). Evaluate the significance of a single high gastric residual volume in relation to other indicators of GI intolerance, including abdominal distention, abdominal discomfort, nausea, and vomiting (AACN, 2018).