A nurse is admitting a 6-month-old infant who has dehydration. Which of the following amounts of urinary output should indicate to the nurse that the treatment has corrected the fluid imbalance?

Choice A reason: A 13% weight loss is not a finding of severe dehydration, but rather of moderate dehydration. Severe dehydration is characterized by a weight loss of more than 15%.

Choice B reason: A rapid pulse is a finding of severe dehydration, as the body tries to compensate for the fluid loss and maintain the blood pressure.

Choice C reason: A bulging anterior fontanel is not a finding of severe dehydration, but rather of increased intracranial pressure. A sunken anterior fontanel is a sign of severe dehydration, as the brain tissue loses water and shrinks.

Choice D reason: Moist mucous membranes are not a finding of severe dehydration, but rather of normal hydration. Dry mucous membranes are a sign of severe dehydration, as the body loses water and electrolytes.

Choice E reason: Decreased urine output is a finding of severe dehydration, as the kidneys try to conserve water and produce less urine. This can lead to renal failure if not corrected.

Choice A reason: Keeping the baby in an upright position after feedings is an effective strategy to prevent or reduce gastroesophageal reflux, as it allows gravity to help the stomach contents stay down. The parent should hold the baby upright for at least 20 to 30 minutes after each feeding, and avoid placing the baby in a car seat or swing, which can increase the abdominal pressure.

Choice B reason: Feeding the baby formula rather than breast milk is not necessary for gastroesophageal reflux, as breast milk is easier to digest and less likely to cause reflux than formula. The parent should continue to breastfeed the baby, unless there is a medical reason to switch to formula. The parent should also avoid overfeeding the baby, and burp the baby frequently during and after feedings.

Choice C reason: Positioning the baby lying on his stomach is not recommended for gastroesophageal reflux, as it can increase the risk of aspiration, suffocation, and sudden infant death syndrome (SIDS). The parent should place the baby on his back to sleep, and elevate the head of the crib or bassinet by 30 degrees to reduce the reflux.

Choice D reason: Thickening the baby's formula with honey is not advised for gastroesophageal reflux, as honey can cause botulism, a serious and potentially fatal illness, in infants under one year of age. The parent should not add any thickening agents to the formula, unless prescribed by the provider. Some studies suggest that thickening the formula with rice cereal may reduce the reflux, but the evidence is inconclusive and the practice may have adverse effects, such as increased caloric intake, constipation, or food allergies.