A nurse is assisting in the care of a 6 year old child who preoperative for repair of a fractured femur.

Exhibits

For each finding click to specify whether the finding indicates no change in the child's condition or is a sign of potential worsening condition.

A. Administering cold formula directly from the refrigerator can cause gastric discomfort and cramping. Formula should be warmed to room temperature before administration.

B. Administering the feeding at a rate of 3 mL/min is too slow for a preschooler. The appropriate rate should be determined based on the child’s tolerance and provider instructions. Continuous feedings are usually given via a pump, while bolus feedings are given over 15–30 minutes.

C. Elevating the head of the bed to a 45-degree angle is the correct action because it helps prevent aspiration and promotes proper digestion. Keeping the child in an upright position during and after the feeding is essential for safety.

D. Discarding residual fluid aspirated from the stomach prior to the feeding is incorrect. Gastric residual volume (GRV) should be measured, but unless it is excessive (per facility protocol), it is usually returned to prevent loss of electrolytes and digestive enzymes.

• Maintain infant on continuous pulse oximetry: Continuous monitoring of oxygen saturation is essential for assessing the infant's respiratory status.
• Maintain infant in supine position: Keeping the infant in a supine position is generally safe and helps with monitoring and care.
• Offer small, frequent feedings: Small, frequent feedings can help maintain the infant's nutritional status and prevent dehydration.
• Monitor intake and output: Monitoring intake and output is crucial for assessing the infant's fluid balance and overall health.
• Initiate a peripheral IV line: Establishing IV access is important for administering medications and fluids as needed.
  

  Provider prescription	Anticipated	Contraindicated
  Maintain infant on continuous pulse oximetry.	✓
  Maintain infant in supine position.	✓
  Offer small, frequent feedings.		✓
  Monitor intake and output.	✓
  Initiate a peripheral IV line.	✓
  Prepare the infant for a chest x-ray.	✓