A charge nurse delegates to an assistive personnel (AP) the task of ambulating a client. At the end of the shift, the nurse discovers the client has not been ambulated. Which of the following actions should the nurse take first?

Rationale:

A. Have teachers and school personnel model healthy eating behaviors: Children learn through observation, and consistent modeling by adults reinforces healthy habits in daily routines. When teachers demonstrate balanced meal choices, students are more likely to adopt similar behaviors. This strategy promotes a supportive environment that normalizes nutritious eating across the school.

B. Recommend removing complex carbohydrate snacks from school vending machines: Complex carbohydrates such as whole-grain items provide sustained energy and support healthy growth. Removing them could encourage replacement with less nutritious options. The goal is to limit high-sugar, high-fat snacks, not to eliminate nutrient-dense foods that benefit the child’s diet.

C. Provide fruits and vegetables as snacks at school sporting events: Offering fresh produce at athletic activities increases children's access to nutritious options during high-energy events. It helps shift the culture away from sugary snacks typically sold at sports venues. This approach supports hydration, recovery, and overall health maintenance in active students.

D. Assist students in developing a recipe book of healthy foods: Engaging children in creating a recipe book encourages active learning and empowers them to make informed food choices. It integrates nutrition education with creativity and helps students build long-term healthy eating skills. Sharing the book can also influence families and the wider community.

E. Offer a dessert to students who finish their lunch: Providing dessert as a reward reinforces unhealthy associations with food and promotes overeating. It teaches children to view sweets as a prize rather than an occasional treat. This approach undermines efforts to build healthy eating patterns and may contribute to long-term poor dietary habits.

Rationale:

A. Restrict daily exercise: Clients with heart failure benefit from regular, moderate activity as tolerated to improve cardiac efficiency and prevent deconditioning. Restricting all exercise can worsen functional status and is not recommended unless specifically limited by the healthcare provider.

B. Encourage 3 large meals per day: Large meals can increase cardiac workload and exacerbate heart failure symptoms due to increased blood flow demands during digestion. Smaller, more frequent meals are preferable to reduce strain on the heart.

C. Limit dietary salt intake: Reducing sodium intake helps prevent fluid retention and edema, which can exacerbate heart failure and increase cardiac workload. Teaching clients to limit salt is a key intervention to manage decreased cardiac output and maintain stable fluid balance.

D. Obtain weight once per week: Daily weight monitoring is recommended for clients with heart failure to detect fluid retention early. Weekly weights may delay recognition of sudden fluid accumulation, increasing the risk of decompensation.