The nurse is giving instructions to parents of a 4-month-old infant with tetralogy of Fallot. Important teaching points should include:

Choice A reason: Clear liquids are not the best intervention for acute diarrhea and dehydration in children. Clear liquids are fluids that are transparent or translucent, such as water, broth, tea, or juice. They may provide some hydration, but they do not contain enough electrolytes (sodium, potassium, chloride) to replace the losses from diarrhea. They may also worsen diarrhea by increasing the osmotic load in the gut.

Choice B reason: Absorbents such as kaolin and pectin are not recommended for acute diarrhea and dehydration in children. Absorbents are substances that bind to toxins, bacteria, or water in the gut, and are supposed to reduce the frequency and volume of stools. However, there is no evidence that they are effective or safe for children with diarrhea. They may also interfere with the absorption of other medications or nutrients.

Choice C reason: Oral rehydration solution (ORS) is the preferred intervention for acute diarrhea and dehydration in children. ORS is a specially formulated solution that contains water, glucose, and electrolytes in the right proportions to replenish the losses from diarrhea. ORS can prevent or treat dehydration, and can also reduce the duration and severity of diarrhea. ORS is widely available, inexpensive, and easy to use. It should be given to children with diarrhea as soon as possible, and continued until the diarrhea stops.

Choice D reason: Antidiarrheal medications are not advised for acute diarrhea and dehydration in children. Antidiarrheal medications are drugs that slow down the movement of the gut, reduce the secretion of fluids, or kill the bacteria that cause diarrhea. However, they are not effective for viral diarrhea, which is the most common cause of diarrhea in children. They may also have serious side effects, such as constipation, abdominal pain, drowsiness, or allergic reactions. They may also mask the symptoms of more serious conditions, such as appendicitis or bowel obstruction.

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.