A nurse positions a patient for the insertion of a nasogastric (NGT) tube by:

Choice A rationale

Introducing whole milk at 6 months is generally too early. At this age, an infant's primary nutrition should still come from breast milk or formula, which are specifically formulated to meet their developmental needs. The infant's digestive system is still maturing and may not be fully ready to process the higher protein and fat content of whole cow's milk.

Choice B rationale

Transitioning to whole milk at 8 months is also typically premature. While some infants might show readiness signs earlier, the American Academy of Pediatrics recommends waiting until closer to 12 months. Introducing whole milk too soon can displace the intake of breast milk or formula, potentially leading to deficiencies in essential nutrients like iron.

Choice C rationale

Waiting until 10 months is closer to the recommended timeframe, but most guidelines still advise waiting until 12 months. This allows the infant's digestive system more time to mature and ensures they receive optimal nutrition from breast milk or formula for a longer duration. Early introduction of whole milk doesn't offer any significant nutritional advantages over breast milk or formula during this period.

Choice D rationale

The American Academy of Pediatrics recommends transitioning to whole cow's milk around 12 months of age for most infants. By this time, their digestive system is more mature and capable of handling the nutrients in whole milk. Additionally, most infants at this age are consuming a wider variety of solid foods, which helps ensure they are meeting their nutritional needs beyond just milk.

Choice A rationale

Adding thickener to fluids helps to increase their viscosity, making them easier to swallow and reducing the risk of aspiration in clients with dysphagia. Dysphagia often results from impaired muscle control in the mouth and throat, and thicker fluids move more slowly, allowing more time for coordination of the swallowing reflex.

Choice B rationale

Placing food on the right side of the client's mouth addresses the left-sided weakness following a stroke. This allows the client to use the stronger, unaffected side of their mouth and throat for better control during chewing and swallowing, minimizing the risk of food pooling on the weaker side and potential aspiration.

Choice C rationale

Serving food at a very hot temperature can impair the client's ability to sense the food in their mouth and can increase the risk of burns, especially with sensory deficits that can occur after a stroke. Warm or room temperature foods are generally recommended for clients with dysphagia to enhance safety and comfort.

Choice D rationale

Instructing the client to tilt her head forward when swallowing helps to close the airway and open the esophagus, facilitating the passage of food and liquids down the throat and reducing the risk of aspiration into the trachea and lungs. This chin-tuck maneuver is a common compensatory strategy for dysphagia. .