A nurse is providing teaching to the parent of a newborn who has gastroesophageal reflux. Which of the following instructions should the nurse include?
"Provide a small feeding just before bedtime."
"Dilute formula with 1 tablespoon of water."
"Position the newborn at a 20-degree angle after feeding."
"Place the newborn in a side-lying position if vomiting."
The Correct Answer is C
Gastroesophageal reflux (GER) is a common condition in infants where the contents of the stomach flow back into the esophagus. It often resolves on its own as the infant grows, but management strategies can help alleviate symptoms. Positioning the newborn upright or at a slight angle after feeding is a key recommendation to reduce reflux episodes.
Now, let's review the rationales for each option:
A) "Provide a small feeding just before bedtime." - Feeding a newborn just before bedtime can exacerbate reflux symptoms as lying down can increase the likelihood of stomach contents refluxing into the esophagus. Therefore, this instruction is not recommended as it may worsen GER symptoms.
B) "Dilute formula with 1 tablespoon of water." - Diluting formula with water can disrupt the balance of nutrients and calories in the formula, potentially affecting the infant's growth and nutritional status. Additionally, diluting formula does not address the underlying cause of GER and is not a recommended practice.
C) "Position the newborn at a 20-degree angle after feeding." - This instruction is correct. Placing the newborn at a 20-degree angle or slightly upright after feeding can help reduce the occurrence of reflux episodes by allowing gravity to assist in keeping stomach contents down. This position helps prevent the backflow of gastric contents into the esophagus and reduces discomfort for the infant.
D) "Place the newborn in a side-lying position if vomiting." - Placing the newborn in a side-lying position after vomiting may increase the risk of aspiration, especially in young infants. It is safer to position the infant upright or at a slight angle to minimize reflux and reduce the risk of aspiration.
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Related Questions
Correct Answer is B
Explanation
A) Almonds: While almonds contain some water content, they are primarily known for their high fat and protein content rather than water. Therefore, they do not contribute significantly to hydration compared to other options.
B) Broccoli: Broccoli is a vegetable with a high water content, making it an excellent choice for maintaining hydration. Vegetables like broccoli typically have a water content of around 90% or higher, providing both water and essential nutrients.
C) Whole-wheat bread: While whole-wheat bread does contain water, its water content is relatively lower compared to fruits and vegetables. Bread typically has a water content of around 35% to 40%, which is lower than options like fruits and vegetables.
D) Cheddar cheese: Cheese, including cheddar cheese, has a very low water content, typically around 35% to 40%. While cheese provides other nutrients like protein and calcium, it is not a significant source of hydration compared to options with higher water content.
Correct Answer is D
Explanation
A) Increased glycosylated hemoglobin (HbA1c) is not an indication of a successful weight loss program. In fact, it typically indicates poor blood sugar control and may suggest worsening diabetes management or insulin resistance. Successful weight loss and improved lifestyle habits should lead to better blood sugar control and a reduction in HbA1c levels.
B) Increased low-density lipoprotein (LDL) cholesterol is not an indication of a successful weight loss program. Elevated LDL cholesterol levels are associated with an increased risk of cardiovascular disease and are often a target for reduction in weight management interventions. Therefore, successful weight loss should be associated with a decrease in LDL cholesterol levels.
C) Increased total cholesterol levels are not indicative of a successful weight loss program. High cholesterol levels, especially when accompanied by elevated LDL cholesterol and decreased high-density lipoprotein (HDL) cholesterol, are associated with an increased risk of cardiovascular disease. Successful weight loss should lead to improvements in lipid profiles, including reductions in total cholesterol levels.
D) Increased high-density lipoprotein (HDL) cholesterol is an indication of a successful weight loss program. HDL cholesterol, often referred to as "good" cholesterol, plays a protective role in cardiovascular health by helping to remove excess cholesterol from the bloodstream and transporting it to the liver for excretion. Higher levels of HDL cholesterol are associated with a reduced risk of cardiovascular disease. Therefore, an increase in HDL cholesterol levels following a weight loss program suggests improved cardiovascular health and metabolic outcomes.
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