Several techniques should be used to confirm proper placement of a feeding tube to prevent harm and to keep the client safe. Which of the following is recommended?

Feeding tube placement must be verified to prevent the catastrophic complication of pulmonary aspiration or pneumothorax. While a chest X-ray remains the "gold standard" for initial verification, bedside nurses must use reliable secondary methods to confirm that the tube remains in the gastric environment before each subsequent use. A. Flushing the tube with water is an intervention to maintain patency, not a method to confirm placement. If the tube is inadvertently placed in the lungs, flushing it with 20 to 30 mL of water could cause respiratory distress or contribute to localized aspiration pneumonia in a compromised patient. B. While capnometry can detect carbon dioxide, which might indicate the tube is in the airway, it is not a widely used or standard bedside technique for routine feeding tube confirmation in most clinical settings. It is an auxiliary tool rather than the primary recommended bedside nursing assessment for enteral tubes. C. Monitoring blood urea nitrogen (BUN), serum protein, and prealbumin levels are methods used to evaluate the patient’s nutritional status and renal function. While important for managing the overall effectiveness of enteral nutrition, these laboratory values provide no information regarding the physical anatomical location of the feeding tube. D. Testing the pH of aspirated gastric contents is a highly recommended bedside method for verifying placement. Gastric acid typically has a pH ≤ 5.0. If the aspirate has a pH > 6.0, it may suggest that the tube is in the respiratory tract or the small intestine, prompting further verification via radiography.