A nurse is teaching the parent of an infant who has a new diagnosis of heart failure about nutrition. Which of the following instructions should the nurse include in the teaching?
Allow the infant to self soothe by crying prior to feeding
Place the infant in a recumbent position during feeding
Implement a 3 hr feeding schedule.
Allow the infant 45 min for each feeding
The Correct Answer is C
A. Allowing the infant to cry before feeding increases energy expenditure and may worsen fatigue in infants with heart failure.
B. A recumbent position can increase the risk of aspiration; a semi-upright position is preferred.
C. Implementing a 3-hour feeding schedule ensures the infant receives adequate nutrition without excessive fatigue.
D. Feedings should be limited to 30 minutes to prevent excessive energy expenditure.
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Related Questions
Correct Answer is D
Explanation
Rationale:
A. Providing the child with a warm blanket can help keep the child comfortable during the course of the illness but initiating airborne precautions is best intervention required.
B. Assessing the oral cavity for Koplik spots is not relevant for varicella, as Koplik spots are associated with measles.
C. Administering aspirin for fever is contraindicated in children with varicella due to the risk of Reye's syndrome.
D. The nurse should initiate airborne precautions, which include placing the child in a private room with negative air pressure, wearing a mask or respirator when entering the room, and limiting visitors and staff exposure. Airborne precautions prevent the transmission of varicella through small droplets that can remain suspended in the air for long periods of time.
Correct Answer is D
Explanation
A. Visual acuity should be assessed for each eye separately first, then both eyes together to detect any differences between the eyes.
B. The nurse should position the child 3 meters (10 feet) from the chart and ask the child to point in the direction of the open end of each letter.
C. If the child wears glasses, they should be tested with and without their glasses to assess visual acuity accurately.
D. A tumbling E chart, where the child identifies the direction of the E (up, down, left, or right), is commonly used for assessing visual acuity in young children who may not yet know letters.
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