A nurse is contributing to the plan of care for a 12-month-old infant following cleft palate repair. Which of the following actions should the nurse include?

To elicit the Moro reflex, the nurse should clap hands after laying the newborn on a flat surface. The Moro reflex, also known as the startle reflex, is an involuntary motor response that infants develop shortly after birth. Loud noises and sudden movements can trigger a baby’s Moro reflex.

Option a is incorrect because turning the newborn's head quickly to one side while they are sleeping may not elicit the Moro reflex.

Option b is incorrect because placing a finger in the newborn's palm may elicit the grasp reflex, not the Moro reflex.

Option d is incorrect because holding the newborn upright with one foot touching the crib surface may not elicit the Moro reflex.

d. Observe the client for 1 hr after meals.

Explanation:

The correct answer is d. Observe the client for 1 hr after meals.

For a client with bulimia nervosa, it is important to closely monitor their behavior after meals to prevent purging behaviors and ensure their safety. Observing the client for 1 hour after meals allows the nurse to provide support, encourage healthy coping strategies, and intervene if necessary to prevent purging episodes.

Option a, administering bupropion 1 hour before meals, is not an appropriate intervention for bulimia nervosa. Bupropion is an antidepressant medication that may be used for certain mood disorders, but it is not the primary treatment for bulimia nervosa.

Option b, allowing the client access to food throughout the day, is not a recommended intervention for a client with bulimia nervosa. Clients with bulimia nervosa often struggle with impulse control and binge eating behaviors. Allowing unrestricted access to food may exacerbate their symptoms and increase the risk of binge-purge cycles.

Option c, weighing the client once weekly, is not the most appropriate intervention for managing bulimia nervosa. While weight monitoring may be a component of treatment, it should not be the sole focus. The treatment for bulimia nervosa involves addressing the underlying psychological and behavioral factors contributing to the disorder.

By recommending the observation of the client for 1 hour after meals, the nurse can provide necessary support, monitor the client for potential purging behaviors, and promote a safe and therapeutic environment for their recovery from bulimia nervosa.