A nurse is caring for an infant who has heart failure and is formula-fed. Which of the following nursing interventions is appropriate to meet the infant's nutritional needs?
Feed the infant at the first sign of hunger.
Use a firm nipple on the bottle when feeding.
Dilute the formula with water to half strength.
Thicken the formula with 1 tsp of rice cereal per ounce.
The Correct Answer is A
A. Infants with HF tire easily; feeding them early, before they are overly fatigued and crying, conserves energy and helps them take in more nutrition. Smaller, more frequent feedings are often recommended.
B. A firm nipple may require more effort to suck, which can be tiring for an infant with heart failure. A softer nipple may be more appropriate.
C. Diluting the formula with water can lead to inadequate caloric intake and nutritional deficiencies. Formula should be prepared according to instructions to ensure proper nutrition.
D. Thickened feeds are sometimes used for reflux, not HF. Adding cereal increases caloric intake but also makes sucking/swallowing more difficult, increasing energy expenditure.
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Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"A"},"F":{"answers":"A"}}
Explanation
Continuous pulse oximetry: Anticipated because the infant has respiratory distress and requires continuous monitoring of oxygen saturation.
Chest x-ray: Anticipated to assess the extent of lung involvement due to the respiratory distress and wheezing noted.
Peripheral IV line: Anticipated since the peripheral line will be used to administer intravenous medications and fluids.
Supine position: Contraindicated because the infant prefers to sit upright and shows signs of respiratory distress, such as nasal flaring and retractions.
Small, frequent feedings: Anticipated to ensure adequate nutrition despite feeding difficulties.
Monitor intake and output: Anticipated to assess hydration status, especially since the infant has had decreased intake and output.
Correct Answer is D
Explanation
A. Restricting fluid intake is not recommended; instead, increasing fluids helps flush out the contrast dye used during the procedure and aids in kidney function.
B. Children typically can return to school within a few days to a week, not 3 to 4 weeks, unless otherwise directed by the physician. Prolonged absence is generally unnecessary unless complications arise.
C. The catheterization site should not have drainage for 3 to 5 days. Any drainage could indicate an infection or other complication and should be evaluated by a healthcare provider.
D. Avoiding baths for the first 3 days helps prevent infection at the catheterization site. Sponge baths are recommended to keep the site clean and dry during the initial healing period.
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