A nurse is caring for a 4-month-old infant diagnosed with gastroesophageal reflux disease (GERD) who is thriving and showing no complications. Which nursing intervention should the nurse prioritize to minimize reflux episodes?

A. "You should be encouraged to eat more of these items to satisfy cravings." is incorrect because consuming non-food items like ice, clay, or dirt can be harmful. These substances may contain toxins or pathogens and can interfere with nutrient absorption. Encouraging this behavior would be unsafe.

B. "This is a normal behavior during pregnancy and does not require intervention." is incorrect because while cravings are common in pregnancy, PICA is an abnormal eating behavior involving non-food items and requires assessment and intervention due to potential health risks.

C. "This behavior, called PICA, may lead to nutritional deficiencies and should be assessed." is correct. PICA is the recurrent consumption of non-nutritive substances and is often associated with iron deficiency anemia and other nutritional deficiencies. The nurse should assess for nutritional status, laboratory abnormalities, and educate the client on potential risks to both mother and fetus.

D. "PICA only occurs in the first trimester and will resolve on its own." is incorrect because PICA can occur at any time during pregnancy and may persist throughout gestation if untreated. It does not resolve spontaneously in all cases.

A. Hydralazine is incorrect because it is an antihypertensive used to lower blood pressure in preeclampsia or eclampsia, but it does not reverse magnesium sulfate toxicity, which is the immediate concern given the symptoms of respiratory depression, oliguria, and absent deep tendon reflexes.

B. Methylergonovine is incorrect because it is a uterotonic used to control postpartum hemorrhage. It is not indicated for magnesium toxicity and would not address the life-threatening respiratory and neuromuscular effects of magnesium sulfate overdose.

C. Calcium gluconate is correct because it is the antidote for magnesium sulfate toxicity. Symptoms of toxicity include respiratory depression (RR <12), oliguria (<30 mL/hr), absent deep tendon reflexes, and eventually cardiac arrhythmias or arrest. Administering 10 mL of 10% calcium gluconate IV over 3–5 minutes can rapidly reverse neuromuscular and cardiac effects while supportive care (e.g., stopping magnesium infusion and monitoring) is continued.

D. Narcan is incorrect because it is an opioid antagonist used to reverse opioid overdose. It has no effect on magnesium sulfate toxicity and would not address the neuromuscular or respiratory compromise in this patient.