A nurse in a pediatric clinic is caring for a child who has iron deficiency anemia and is prescribed ferrous sulfate. Which of the following instructions should the nurse provide the parents regarding administration of this medication?

Choice A reason: Bleeding precaution is indicated for a child who has leukemia and a critically low platelet count, as it reduces the risk of hemorrhage and injury. The nurse should monitor the child for signs of bleeding, such as petechiae, ecchymosis, epistaxis, hematuria, and melena. The nurse should also avoid invasive procedures, use soft-bristled toothbrushes, apply pressure to venipuncture sites, and administer platelet transfusions as prescribed.

Choice B reason: Droplet precaution is not indicated for a child who has leukemia and a critically low platelet count, unless the child has a respiratory infection that is transmitted by droplets. Droplet precaution involves wearing a mask when within 3 feet of the child, and placing the child in a private room or with a roommate who has the same infection.

Choice C reason: Neutropenic precaution is indicated for a child who has leukemia and a critically low neutrophil count, as it reduces the risk of infection and sepsis. Neutropenic precaution involves placing the child in a private room with positive pressure airflow, wearing gloves, gown, and mask when entering the room, and restricting visitors who are ill or immunocompromised.

Choice D reason: Contact precaution is not indicated for a child who has leukemia and a critically low platelet count, unless the child has a skin or wound infection that is transmitted by direct or indirect contact. Contact precaution involves wearing gloves and gown when entering the room, and placing the child in a private room or with a roommate who has the same infection.

The correct answer is: B. I will add Polycose to each of my baby's bottles.

Choice A reason:

Allowing the baby to take as much time as needed to finish the bottle is not ideal for infants with heart failure. These infants often tire easily and may not consume enough calories if feeding sessions are prolonged. Shorter, more frequent feedings are generally recommended to ensure adequate intake without exhausting the infant.

Choice B reason:

Adding Polycose to each bottle is an effective way to increase the caloric density of the infant's feedings. Infants with heart failure have higher caloric needs due to their increased metabolic demands and may struggle to consume enough calories through regular formula or breast milk alone. Polycose, a carbohydrate supplement, helps meet these increased nutritional needs.

Choice C reason:

Feeding the baby on a schedule every 4 hours may not be sufficient for an infant with heart failure. These infants often require more frequent feedings to meet their caloric needs and to prevent fatigue during feeding. Feeding every 1-3 hours is typically recommended to ensure they receive adequate nutrition.

Choice D reason:

Limiting the baby's crying to 15 minutes prior to each feeding does not directly address the nutritional needs of an infant with heart failure. While managing crying is important to reduce energy expenditure, the focus should be on providing adequate nutrition through frequent, high-calorie feedings.