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. Restrict the child's diet to low-calorie foods to prevent obesity is incorrect because children with cerebral palsy are at risk for undernutrition due to feeding difficulties and increased energy expenditure from spasticity. Restricting calories could impair growth and development rather than prevent obesity, so diet should focus on balanced nutrition and adequate caloric intake.

B. Encourage daily passive range-of-motion exercises is correct because spasticity and limited mobility in cerebral palsy can lead to contractures and joint deformities. Daily passive range-of-motion exercises help maintain joint flexibility, prevent contractures, promote circulation, and support functional mobility, which are critical in early intervention for children with cerebral palsy.

C. Avoid physical therapy until the child can walk independently is incorrect because delaying therapy misses a critical window for neurodevelopmental intervention. Early and consistent physical therapy is essential to maximize motor function, improve strength, and prevent complications, regardless of the child’s ability to walk independently.

D. Promote strict bed rest to prevent fatigue is incorrect because immobilization exacerbates muscle stiffness, spasticity, and joint contractures. Children with cerebral palsy benefit from structured activity and therapy, even if it induces mild fatigue, as this promotes motor skill development and overall function.

A. Visual Analog Scale (VAS) is incorrect because it requires the child to understand and mark a point on a line to represent pain intensity, which is often too complex for a 4-year-old, especially if they cannot verbalize pain reliably.

B. FLACC scale is correct. The FLACC (Face, Legs, Activity, Cry, Consolability) scale is an observational tool designed for children who cannot self-report pain. It assesses behavioral and physiological indicators of pain including facial expression, leg movement, activity level, crying, and consolability. Scores range from 0 to 10, allowing for objective assessment and monitoring of pain in young children, infants, or nonverbal patients.

C. Faces Pain Scale is incorrect because it relies on the child’s ability to understand and point to a facial expression that represents their pain. While appropriate for some preschoolers, a 4-year-old who cannot reliably verbalize or comprehend the scale may not use it accurately.

D. Numeric Rating Scale is incorrect because it requires the child to assign a number (0–10) to describe pain, which is generally suitable for children aged 7 and older who can understand abstract numerical concepts.