A nurse is providing teaching to the guardian of an 11-month-old infant who has acute diarrhea. Which of the following food items should the nurse instruct the parent to provide to the infant?

Condition Most Likely Experiencing: C

Actions to Take: A, B

Parameters to Monitor: B, C

Rationale:

Condition Most Likely Experiencing

A. Pyloric stenosis causes projectile vomiting, dehydration, and hunger.

B. Cystic fibrosis causes chronic respiratory infections, steatorrhea, and failure to thrive.

C. The condition that the infant is most likely experiencing is congestive heart failure, which can cause poor weight gain, tachypnea, decreased appetite, and periorbital edema.

D. Respiratory syncytial virus bronchiolitis causes wheezing, coughing, and respiratory distress.

Actions to Take

A. Digoxin is a medication commonly prescribed to manage congestive heart failure in infants by improving cardiac contractility and reducing heart rate.

B. Elevating the head of the bed helps reduce venous return to the heart, thereby decreasing preload and relieving symptoms of congestion in congestive heart failure.

C. Contact precautions are not indicated for congestive heart failure, but for infections that are transmitted by direct or indirect contact.

D. Chest physiotherapy and postural drainage are not indicated for congestive heart failure, but for conditions that cause excessive mucus production and retention.

Parameters to Monitor

A. Number of steatorrhea stools is not relevant for congestive heart failure, but for cystic fibrosis or other malabsorption disorders.

B. Monitoring intake and output is crucial in assessing fluid balance, especially in congestive heart failure where fluid retention can lead to volume overload.

C. Monitoring respiratory status is essential in congestive heart failure to assess for signs of pulmonary congestion and respiratory distress, such as tachypnea, retractions, and crackles.

D. Presence of periorbital edema is not a parameter to monitor, but a sign of fluid overload.

Anticipated

Sulfamethoxazole and trimethoprim are antibiotics commonly used to treat urinary tract infections. Administering the prescribed antibiotic is appropriate for treating the UTI.

Advising the child's guardian about the use of sunscreen is appropriate, especially if the child will be using sulfamethoxazole and trimethoprim which causes photosensitivity.

Proper perineal hygiene is essential in preventing recurrent urinary tract infections. Teaching the child about proper hygiene practices is important for preventing future UTIs.

Contraindicated

Salicylic acid (aspirin) is contraindicated in children with viral infections due to the risk of Reye's syndrome, a rare but serious condition. Since the child has a fever, which is likely due to the UTI, salicylic acid should not be given.

Fluid intake should be encouraged to help flush out the bacteria causing the UTI. Restricting fluid intake is not appropriate in this situation.