A nurse is assessing a child who has a congenital heart defect. The nurse should recognize that which of the following defects is associated with increased pulmonary blood flow?

A. Ophthalmologist: This healthcare professional specializes in the diagnosis and treatment of eye disorders. While eye problems can occur in infants, congenital talipes equinovarus specifically involves foot deformities rather than eye issues. Therefore, a referral to an ophthalmologist wouldn't be appropriate for this condition.

B. Nutrition counselor: A nutrition counselor provides guidance on diet and nutrition-related issues. While nutrition is essential for overall health, it's not directly related to the treatment of congenital talipes equinovarus. Therefore, a referral to a nutrition counselor wouldn't typically be part of the care plan for this condition.

C. Speech therapist: Speech therapists, also known as speech-language pathologists, specialize in evaluating and treating communication and swallowing disorders. However, congenital talipes equinovarus doesn't affect speech or swallowing. Therefore, a referral to a speech therapist wouldn't be relevant for this condition.

D. Orthopedic specialist: An orthopedic specialist is a healthcare professional who specializes in the diagnosis and treatment of musculoskeletal conditions, including congenital abnormalities like clubfoot. They are trained to assess the severity of the deformity and develop a treatment plan, which may include non-surgical or surgical interventions to correct the foot alignment. Therefore, a referral to an orthopedic specialist is the most appropriate choice for an infant with congenital talipes equinovarus.

A. "What is your pain level right now?": This response doesn't directly address the child's question about mortality and may deflect the conversation away from the child's concerns. While assessing pain is important, it should not be the immediate response to a question about mortality.

B. "Your doctor will be able to answer your questions tomorrow.": This response delays addressing the child's concerns and may leave the child feeling anxious or unsupported in the meantime. It's important for the nurse to provide immediate support and reassurance when a child expresses fears or worries.

C. "It sounds like you are worried. Tell me what you have been told.": This response acknowledges the child's emotions and invites them to share their thoughts and concerns. It opens up a dialogue between the nurse and the child, allowing the nurse to provide appropriate support and information based on the child's understanding and perspective.

D. "It's natural to worry about death, but you should focus your energy on getting better.": While this response acknowledges the child's worry, it may come across as dismissive or minimizing of the child's concerns about mortality. It's important to validate the child's emotions and offer support rather than redirecting their focus away from their worries.