The nurse is caring for infants with the following conditions. Which infants would be at risk for failure to thrive? Select all that apply.

Choice A reason: Having the patient sit on the side of the bed before standing is crucial to prevent dizziness or fainting, especially after giving birth. This intervention allows the patient to stabilize and ensures that they do not experience sudden drops in blood pressure, which can lead to falls.

Choice B reason: Walking alongside the patient to the bathroom is important to provide support and ensure their safety. The patient may still be weak or unsteady after giving birth, and having the nurse nearby can help prevent falls and provide assistance if needed.

Choice C reason: Obtaining an oral temperature is not immediately necessary when assisting a patient to the bathroom post-vaginal birth. While monitoring vital signs is important, this intervention does not directly contribute to the immediate need for safe ambulation.

Choice D reason: Assessing for sensation in the lower extremities is essential to ensure that the patient has regained feeling and control in their legs. This assessment helps to determine if there are any residual effects from epidural anaesthesia or other factors that may affect mobility and safety.

Choice E reason: Assessing bowel sounds and passing flatus is important for overall postpartum care but is not directly related to assisting the patient to the bathroom. This intervention is more relevant to monitoring gastrointestinal recovery and function after childbirth.

Choice A reason: While it is true that children may become anxious when they have to be in a health care setting, this statement does not specifically address the unique situation of a child with atrial septal defect (ASD). The diagnosis of ASD can contribute to an increased risk of anxiety due to the underlying health condition and its implications, rather than just the health care setting alone.

Choice B reason: Children with atrial septal defect (ASD) are indeed at a greater risk for experiencing anxiety. The presence of a congenital heart condition can create significant stress and worry for the child and their family. The anxiety could stem from concerns about their health, potential treatments, and the impact of the condition on their daily life. Therefore, this response appropriately acknowledges the connection between the diagnosis of ASD and the increased anxiety levels observed in the child.

Choice C reason: Although children with atrial septal defect may experience anxiety, the statement that children with ASD have mood disorders is not necessarily accurate. Mood disorders and anxiety are distinct conditions, and while they can co-occur, it is not a given that a child with ASD will have mood disorders. Thus, this response is not entirely appropriate for addressing the caregivers' concern.

Choice D reason: Worrying can be considered normal for children in general; however, this response does not specifically address the context of the child's atrial septal defect (ASD) and its potential impact on their anxiety levels. This statement is too generalized and does not provide the caregivers with the necessary reassurance and information related to the diagnosis of ASD. Therefore, it is not the most appropriate response from the nurse.