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

Answer and Explanation

The Correct Answer is C

A. Allowing the infant to self-soothe by crying prior to feeding is not appropriate, as it may lead to increased stress and fatigue, which can worsen heart failure symptoms.

B. Placing the infant in an upright position during feeding helps to reduce the risk of aspiration and promotes effective swallowing.

C. Infants with heart failure have a weakened heart that struggles to pump blood efficiently. Feeding can be tiring for them, and they might not be able to consume large volumes at once. A smaller, more frequent feeding schedule allows them to take in enough calories without overexertion. This approach helps manage their energy expenditure and reduces stress on the heart.

D. While some infants might take longer to feed, heart failure can make feeding tiring. Offering smaller, more frequent feedings can help the infant consume enough calories without expending too much energy.

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Correct Answer is B

Explanation

A. Setting the water heater to 60° C (140° F) increases the risk of scald burns for toddlers due to hot water. This is not a recommended safety measure.
B. Keeping electrical wires hidden from view helps prevent electrical burns, which is a significant risk for toddlers who may touch or play with exposed wires.
C. Encouraging outdoor activities between 1100 and 1300 may expose toddlers to the sun during peak hours, increasing the risk of sunburns, but it does not directly address burn prevention.
D. Turning pot handles toward the front of the stove helps prevent toddlers from reaching up and pulling hot pots down, reducing the risk of burns. While a good safety measure, it is not as directly related to burn prevention as hiding electrical wires.

A. “Discontinue this medication if gastrointestinal upset occurs.” B. “Limit your child’s intake of potassium-rich foods.” C. “Expect that this medication will stimulate a growth spurt.” D. Monitor your child for indications of infection.”

Correct Answer is D

Explanation

A. Instructing the parent to discontinue prednisone if gastrointestinal upset occurs is not appropriate, as abrupt discontinuation of corticosteroids can lead to adrenal insufficiency. Monitoring for and managing gastrointestinal upset while continuing the medication as prescribed is more appropriate.
B. Limiting intake of potassium-rich foods is not specifically indicated with prednisone therapy. Prednisone may increase the risk of potassium loss, but dietary adjustments should be made under medical guidance.
C. Prednisone can affect growth in children, but it is more commonly associated with slowing growth rather than stimulating a growth spurt. This statement is misleading and not accurate.
D. Monitoring the child for indications of infection is crucial when taking prednisone, as corticosteroids can suppress the immune system and increase susceptibility to infections. This statement addresses an important aspect of medication safety and is the priority in discharge teaching.

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