The nurse is promoting a healthy diet to guide a mother when feeding her 2-week-old girl. Which is the most effective anticipatory guidance?

Substituting cow's milk if breast milk is not available

Advising fluid intake per feeding of 5 or 6 ounces

Advocating iron supplements with bottle-feeding

Discouraging the addition of fruit juice to the diet

Answer and Explanation

The Correct Answer is D

A. Substituting cow's milk if breast milk is not availablE. Cow's milk is not recommended as a substitute for breast milk or infant formula for infants under 12 months old due to its low iron content and potential for causing gastrointestinal irritation.

B. Advising fluid intake per feeding of 5 or 6 ounces: The appropriate fluid intake for a 2-week- old infant is typically guided by feeding cues and may vary from feeding to feeding. Providing a specific volume of fluid per feeding may not be appropriate, as infants should be fed on demand.

C. Advocating iron supplements with bottle-feeding: Iron supplementation is generally recommended for breastfed infants starting at around 4 months of age, but it is not typically necessary for formula-fed infants during the first few weeks of life. Additionally, iron

supplementation should be prescribed and monitored by a healthcare provider rather than advocated as a general guideline.

D. Discouraging the addition of fruit juice to the diet: This is the most effective anticipatory guidance because it aligns with current recommendations from pediatric healthcare

organizations. Fruit juice offers little nutritional value for infants and can contribute to dental caries and excessive calorie intake. It is generally recommended to avoid giving fruit juice to infants under 1 year old.

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Correct Answer is C

Explanation

A. The child does not vocally respond to voices: While vocal responsiveness is an important aspect of development, it may vary among infants and is not necessarily indicative of a developmental problem at 4 months.

B. The child never squeals or yells: Squealing and yelling are vocalizations that infants may or may not exhibit at this age, and their absence alone may not necessarily indicate a developmental problem.

C. The child does not babblE. Babbling, which typically begins around 4 to 6 months of age, involves the repetition of consonant-vowel combinations (e.g., "bababa"). The absence of babbling by 4 months may suggest a delay in language development and could be a potential sign of a developmental problem.

D. The child does not say dada or mamA. Infants may begin to associate "dada" or "mama" with specific caregivers, but this typically occurs later, closer to 6 to 9 months of age. The absence of this behavior at 4 months may not necessarily indicate a developmental problem.

A. Use quick deliberate gestures to get your point across. B. Allow the child to control the pace and order of the health history. C. Do not make physical contact with the child during the interview. D. Wear a white examination coat when conducting the interview.

Correct Answer is B

Explanation

A. Use quick deliberate gestures to get your point across.

Using quick gestures may intimidate or overwhelm the child, potentially hindering communication. It's essential to approach the child with patience and attentiveness.

B. Allow the child to control the pace and order of the health history.

Allowing the child to dictate the pace and sequence of the health history empowers them and helps build trust. It allows the child to express themselves comfortably and share relevant

information at their own pace.

C. Do not make physical contact with the child during the interview.

While respecting the child's personal space is important, appropriate physical contact, such as a reassuring touch or handshake, can help establish rapport and comfort during the interview.

D. Wear a white examination coat when conducting the interview.

Wearing a white coat may create a sense of formality and authority that could intimidate the child. Opting for attire that is approachable and friendly can help put the child at ease and facilitate open communication.

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