Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse's reply should be based on which statement?

Choice A reason: Making the patient NPO (nothing by mouth) is not an appropriate intervention for CHF. NPO status may be indicated for other reasons, such as before surgery or certain tests, but it does not address the fluid overload or poor cardiac function that causes CHF.

Choice B reason: Administering diuretics is a common and effective intervention for CHF. Diuretics help reduce the excess fluid in the body and lungs, which improves breathing and lowers blood pressure. Diuretics also decrease the workload of the heart and prevent further damage to the cardiac muscles.

Choice C reason: Administering antipyretics is not a specific intervention for CHF. Antipyretics are used to lower fever, which may or may not be present in CHF. Fever may indicate an infection, which can worsen CHF, but antipyretics alone do not treat the underlying cause of the infection or the CHF.

Choice D reason: Providing IV bolus is not a recommended intervention for CHF. IV bolus is a rapid infusion of fluid or medication into the bloodstream. This may increase the fluid volume and pressure in the body and lungs, which can exacerbate CHF and cause pulmonary edema. IV bolus may be used for other conditions, such as hypovolemic shock or dehydration, but not for CHF.

Choice A reason: Giving the toddler planned, frequent, and nutritious snacks is a good way to meet her nutritional needs and respect her natural appetite. Toddlers have small stomachs and high energy levels, so they may not eat much at one sitting. They may also be easily distracted or bored by sitting at the table for too long. Snacks can provide additional calories and nutrients that they may miss at mealtimes. However, the snacks should be healthy, such as fruits, vegetables, cheese, yogurt, or whole-grain crackers. They should also be offered at regular times, not on demand, and not too close to mealtimes.

Choice B reason: Explaining to the toddler in a firm manner what is expected of her is not a helpful or realistic strategy to improve her eating habits. Toddlers are naturally curious and independent, and they may not understand or follow the rules that adults set for them. They may also resist or rebel against pressure or coercion to eat. Instead of lecturing or scolding the toddler, the parents should model good eating behaviors, praise her when she tries new foods, and avoid power struggles or arguments over food.

Choice C reason: Avoiding snacks so the toddler is hungry at mealtimes is not a wise or healthy suggestion. This may backfire and cause the toddler to become more fussy, irritable, or tired. It may also lead to overeating, bingeing, or unhealthy food choices later on. Hunger is not the only factor that influences a toddler's appetite. Other factors include mood, activity level, environment, and preferences. The parents should not use hunger as a tool to manipulate the toddler's eating, but rather respect her hunger and fullness cues.

Choice D reason: Offering rewards for eating at mealtimes is not a beneficial or sustainable method to encourage the toddler to eat. Rewards may be material, such as toys or stickers, or edible, such as sweets or desserts. Rewards may work temporarily, but they may also have negative consequences. They may undermine the toddler's intrinsic motivation to eat, or make her associate eating with external rewards rather than internal satisfaction. They may also create an imbalance in the value of different foods, or make the toddler feel guilty or deprived. The parents should not bribe or bargain with the toddler to eat, but rather make eating a pleasant and enjoyable experience.