A nurse is caring for a client who is receiving continuous enteral feedings. Which of the following actions should the nurse take? (Select all that apply.)

A. Check gastric residuals every 4 hr: Monitoring gastric residual volume every 4 hours helps assess tolerance to the feeding and prevents aspiration or overfeeding. B. Ensure the formula is cold before administration: Cold formula can cause gastric cramping and discomfort. It should be at room temperature prior to administration. C. Check placement of the feeding tube x-ray once daily: X-ray confirmation is typically done once upon initial insertion. Daily checks are not required unless there’s a concern about displacement. D. Change the feeding container and tubing every 24 hr: This reduces the risk of bacterial contamination, especially since enteral nutrition provides a medium for microbial growth. E. Maintain the head of the client’s bed at a 30° angle or higher: Elevating the head of the bed helps prevent aspiration by keeping gastric contents from refluxing into the esophagus.