A nurse is caring for a five-year-old client in a primary care clinic. Which of the following actions would the nurse expect to take in this setting? (Select All that Apply.)

A. “There is an increased workload on the right side of the heart, making the muscle thinner and harder for the heart to pump blood through the body.": Cardiomyopathy typically involves the ventricles rather than just the right side of the heart, and ventricular muscle often becomes thickened or dilated rather than thinner initially.

B. "There is an increased workload on the left side of the heart, making the muscle thicker and harder for the heart to pump blood through the body.": While left-sided involvement can occur, cardiomyopathy often affects both ventricles, not solely the left side.

C. “There is an increased workload in the right and left atria, making the muscle thinner and harder for the heart to pump blood through the body.": The atria are not the primary sites affected in cardiomyopathy; pathology predominantly affects the ventricles, which manage the major pumping workload.

D. “There is an increased workload in the right and left ventricles, making the muscle thicker and harder for the heart to pump blood through the body.": Cardiomyopathy causes the ventricular muscle to undergo hypertrophy or dilation due to increased workload, impairing effective pumping. This accurately reflects the pathophysiology and ventricular involvement.

A. "Formula feeding is easier and will let you get more rest, so it's definitely the better option now.": This statement introduces personal judgment and implies superiority of one feeding method over another. It may invalidate the mother’s autonomy and oversimplifies infant feeding decisions. Nursing communication should remain neutral and supportive rather than directive or comparative.

B. "I can help you learn how to properly prepare and safely store formula to ensure your infant receives safe nutrition.": This response respects the mother’s informed choice while prioritizing infant safety and adequate nutrition. Teaching correct formula preparation, dilution, and storage reduces the risk of infection, electrolyte imbalance, and inadequate caloric intake. It reflects patient-centered, nonjudgmental nursing care.

C. "Since formula feeding is not as beneficial as breastfeeding, you should only use it as a last resort.": This statement is judgmental and may increase parental guilt or distress. While breastfeeding has immunologic benefits, formula feeding can fully support normal growth when used correctly. Nursing support should focus on safe feeding practices rather than persuasion.

D. "Breastfeeding provides better immunity, so I strongly recommend you reconsider and continue breastfeeding.": This response disregards the mother’s decision and undermines autonomy. Pressuring the parent may damage trust and does not address the immediate need for education on formula use. Supportive counseling should align with the family’s chosen feeding method.