A nurse is caring for an 18-month-old toddler in the emergency department who has Kawasaki disease. The nurse reviews the toddler's medical record and assessment findings. Which of the following provider prescriptions should the nurse anticipate?

Choice A reason: 60 beats per minute is too low for an infant's apical heart rate. The normal range for a 6-month-old infant is 100 to 160 beats per minute. A low heart rate can indicate digoxin toxicity, which can cause serious complications such as bradycardia, arrhythmias, and cardiac arrest.

Choice B reason: 80 beats per minute is also too low for an infant's apical heart rate. The normal range for a 6-month-old infant is 100 to 160 beats per minute. A low heart rate can indicate digoxin toxicity, which can cause serious complications such as bradycardia, arrhythmias, and cardiac arrest.

Choice C reason: 100 beats per minute is the lower limit of the normal range for a 6-month-old infant's apical heart rate. The nurse should withhold the dose of digoxin if the infant's apical heart rate is less than 100 beats per minute, as this can indicate digoxin toxicity, which can cause serious complications such as bradycardia, arrhythmias, and cardiac arrest.

Choice D reason: 120 beats per minute is within the normal range for a 6-month-old infant's apical heart rate. The nurse does not need to withhold the dose of digoxin if the infant's apical heart rate is 120 beats per minute, as this does not indicate digoxin toxicity. However, the nurse should still monitor the infant's heart rate, blood pressure, and digoxin level closely, as digoxin has a narrow therapeutic window and can cause adverse effects even at therapeutic doses.

The correct answer is: B. I will add Polycose to each of my baby's bottles.

Choice A reason:

Allowing the baby to take as much time as needed to finish the bottle is not ideal for infants with heart failure. These infants often tire easily and may not consume enough calories if feeding sessions are prolonged. Shorter, more frequent feedings are generally recommended to ensure adequate intake without exhausting the infant.

Choice B reason:

Adding Polycose to each bottle is an effective way to increase the caloric density of the infant's feedings. Infants with heart failure have higher caloric needs due to their increased metabolic demands and may struggle to consume enough calories through regular formula or breast milk alone. Polycose, a carbohydrate supplement, helps meet these increased nutritional needs.

Choice C reason:

Feeding the baby on a schedule every 4 hours may not be sufficient for an infant with heart failure. These infants often require more frequent feedings to meet their caloric needs and to prevent fatigue during feeding. Feeding every 1-3 hours is typically recommended to ensure they receive adequate nutrition.

Choice D reason:

Limiting the baby's crying to 15 minutes prior to each feeding does not directly address the nutritional needs of an infant with heart failure. While managing crying is important to reduce energy expenditure, the focus should be on providing adequate nutrition through frequent, high-calorie feedings.