A nurse is collecting data from an infant who has otitis media.
Which of the following findings should the nurse identify as manifestations of pain in an infant? (Select all that apply)

Choice A rationale

The American Academy of Pediatrics and the Dietary Guidelines for Americans recommend that children be introduced to foods other than breast milk or infant formula when they are about 6 months old. The first foods to be introduced should be single-ingredient foods that contain no sugar or salt. Among the first foods to be introduced are infant cereals. Iron-fortified cereals are particularly important because iron is a crucial nutrient in the second half of a baby’s first year.

Choice B rationale

While strained fruits are a common food to introduce early on, they are typically not the first food to be introduced. The first food is usually an iron-fortified cereal due to the importance of iron in a baby’s diet.

Choice C rationale

Pureed meats are also a good source of iron and can be introduced early on. However, they are not typically the first food to be introduced.

Choice D rationale

Cooked egg whites are not typically one of the first foods introduced to infants. There is also a risk of allergic reactions with egg whites, so they should be introduced with caution and not as the first food.

Choice A rationale

The statement “My baby will be placed under special lights if the test is elevated” indicates a need for further teaching. This statement is incorrect because phototherapy (special lights) is not used to treat phenylketonuria (PKU). PKU is a genetic disorder that results in the body’s inability to metabolize the amino acid phenylalanine. If left untreated, it can lead to intellectual disability and other serious health problems. The treatment for PKU involves a special diet that is low in phenylalanine. Therefore, the parent’s statement about using special lights for treatment indicates a misunderstanding about the nature of PKU and its treatment.

Choice B rationale

The statement “Sometimes the test is repeated in the doctor’s office at the 2-week check-up” is correct. PKU is usually diagnosed through a routine newborn screening test, and if the initial test results are positive or unclear, the test may be repeated.

Choice C rationale

The statement “My baby must take formula or breast milk before the test is done” is correct. For accurate results, the PKU test is done after the baby is 24 hours old and after the baby has had some protein in the diet.

Choice D rationale

The statement “This test checks for a genetic disorder that can be corrected by diet” is correct. PKU is a genetic disorder that can be managed with a special diet low in phenylalanine.