An unlicensed assistive personnel (UAP) applies a pediatric urine collection (PUC) bag on the symphysis pubis of a female infant.
Which action is most important for the practical nurse (PN) to take when checking the placement of the PUC bag?

Choice A rationale

Consumption of whole milk as a toddler is generally appropriate for growth and development, providing essential fats and nutrients. Unless consumed in excessive quantities or as part of an overall diet high in calories without sufficient physical activity, it is not typically identified as a primary singular contributor to early obesity.

Choice B rationale

Dedicated breastfeeding for 6 months is protective against childhood obesity. Breast milk provides optimal nutrition and growth-promoting factors, and breastfeeding is associated with better self-regulation of caloric intake by infants, potentially reducing the risk of later obesity compared to formula feeding.

Choice C rationale

Exclusive soy-based formula for the first year, while an alternative for specific dietary needs, does not inherently contribute to early obesity more than other formulas. The caloric density and nutritional composition of standard infant formulas are regulated and designed to support healthy growth, making it unlikely to be a primary cause of obesity.

Choice D rationale

Introducing solid foods, such as fortified cereal, before 4 months of age is associated with an increased risk of obesity. Infants lack the necessary gastrointestinal and renal maturity to process solids effectively before this age, and early introduction can lead to excessive caloric intake, disruption of feeding cues, and altered gut microbiome development, predisposing to weight gain.

Choice A rationale

While postpartum depression is a serious concern, immediately asking about suicidal thoughts without first establishing a broader understanding of the client's feelings can be premature and potentially alienating. It is essential to first assess the general emotional state and bonding difficulties before jumping to severe mental health concerns.

Choice B rationale

Explaining that this is a common feeling can minimize the client's distress and validate her experience, but it does not provide an avenue for her to express her specific concerns or for the PN to fully assess the depth of her feelings. It can prematurely close off further discussion and assessment.

Choice C rationale

Determining if her husband is bonding with the baby shifts the focus away from the client's own feelings and experiences, which is the primary concern in this situation. While partner involvement is important, the immediate priority is to understand and address the client's reported lack of bonding.

Choice D rationale

Encouraging the client to talk about her feelings provides an open and supportive environment for her to express her specific concerns regarding bonding. This allows the practical nurse to gather more information, assess the severity of the issue, and identify appropriate interventions or referrals if needed, promoting therapeutic communication.