A nurse is providing teaching to the parent of a newborn who has gastroesophageal reflux (GER). Which of the following instructions should the nurse include?
Dilute formula with 1 tablespoon of water.
Place the newborn in a side-lying position if vomiting.
Position the newborn at a 20-degree angle after feeding.
Provide a small feeding just before bedtime.
The Correct Answer is C
Choice A reason: Dilute formula with 1 tablespoon of water is not a correct instruction for GER. Diluting formula can reduce the nutritional value and increase the volume of the feedings, which can worsen GER symptoms and cause dehydration and malnutrition.
Choice B reason: Place the newborn in a side-lying position if vomiting is not a correct instruction for GER. This position can increase the risk of aspiration, which is the inhalation of vomit into the lungs. Aspiration can cause pneumonia, respiratory distress, and death.
Choice C reason: Position the newborn at a 20-degree angle after feeding is a correct instruction for GER. This position can help prevent reflux by using gravity to keep the stomach contents down. The newborn should be kept upright for at least 30 minutes after each feeding.
Choice D reason: Provide a small feeding just before bedtime is not a correct instruction for GER. This can increase the likelihood of reflux during sleep, as the stomach will be full and prone to regurgitation. The last feeding should be given at least 2 to 3 hours before bedtime.
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Related Questions
Correct Answer is C
Explanation
Choice A reason: Including a high-fat food with each meal is not a good strategy for managing chronic nausea during pregnancy because it can delay gastric emptying and worsen nausea and vomiting. High-fat foods should be avoided or consumed in moderation during pregnancy.
Choice B reason: Drinking 12 ounces of water with breakfast is not a good strategy for managing chronic nausea during pregnancy because it can dilute stomach acid and trigger nausea and vomiting. Water should be consumed between meals rather than with meals during pregnancy.
Choice C reason: Eating a high-carbohydrate diet is a good strategy for managing chronic nausea during pregnancy because it can provide quick energy and prevent hypoglycemia, which can cause nausea and vomiting. Carbohydrate-rich foods, such as crackers, toast, rice, and cereal, can also absorb stomach acid and reduce nausea and vomiting.
Choice D reason: Lying down for an hour after eating is not a good strategy for managing chronic nausea during pregnancy because it can cause acid reflux and worsen nausea and vomiting. It is better to sit upright or walk for a few minutes after eating during pregnancy.
Correct Answer is C
Explanation
Choice A reason: Using liquids to clear food from the client's mouth is not a safe intervention for dysphagia. Liquids can easily enter the airway and cause aspiration, which is the inhalation of food or fluids into the lungs. Aspiration can lead to pneumonia, respiratory distress, and death.
Choice B reason: Tilting the client's head backwards to facilitate swallowing is not a safe intervention for dysphagia. This position can also increase the risk of aspiration, as it opens the airway and allows food or fluids to flow into it.
Choice C reason: Adding a thickening agent to liquids is a safe and effective intervention for dysphagia. Thickened liquids are easier to swallow and control, as they move more slowly through the mouth and throat. They also reduce the risk of aspiration, as they are less likely to enter the airway.
Choice D reason: Placing the client in a semi-Fowler's position is not a safe intervention for dysphagia. This position can also increase the risk of aspiration, as it lowers the head and neck and reduces the closure of the airway. A better position for dysphagia is upright or high-Fowler's, which elevates the head and neck and enhances the closure of the airway.
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