A nurse is contributing to the plan of care for an infant who has heart failure. Which of the following interventions should the nurse recommend?

Provide feedings every 3 hr.

Dilute formula to half strength.

Place the infant in lateral position during feeding.

Implement bolus gavage feedings.

Answer and Explanation

The Correct Answer is A

A. Infants with heart failure may experience fatigue during feeding, so smaller, more frequent feedings are recommended to prevent exhaustion and ensure adequate nutrition. Feedings every 3 hours are typically recommended to maintain a steady intake without overexertion.

B. Diluting formula to half strength is not recommended for an infant with heart failure, as it can lead to malnutrition and insufficient caloric intake. The formula should be provided at normal strength.

C. Placing the infant in a lateral position during feeding could be unsafe, as it may increase the risk of aspiration. The infant should generally be fed in an upright or semi-upright position to reduce aspiration risk and promote optimal digestion.

D. Bolus gavage feedings are typically used for infants who are unable to feed orally due to medical conditions, but for a child with heart failure who is feeding orally, more frequent and smaller feedings would be preferable.

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Correct Answer is C

Explanation

A. Weight above the 10th percentile would not be expected in an infant with failure to thrive. Infants with failure to thrive typically exhibit weight below the 5th percentile due to insufficient caloric intake or absorption.

B. Making eye contact with others is a normal developmental milestone at 11 months and would not be expected to be impaired in a child with failure to thrive.

C. Poor muscle tone is a common finding in infants with failure to thrive, as malnutrition and inadequate nourishment can affect the development of muscle strength and coordination.

D. Stranger anxiety is a typical developmental stage at 11 months, but it is not associated with failure to thrive. Infants with failure to thrive may exhibit developmental delays, but stranger anxiety is not a primary concern.

A. Wooden building blocks B. Stringing beads C. Colored paper and safety scissors D. Alphabet flash cards

Correct Answer is A

Explanation

A. Wooden building blocks are appropriate for an 18-month-old child, as they promote motor skills development, coordination, and creativity. At this age, children engage in parallel play and are developing their ability to manipulate objects.

B. Stringing beads requires more advanced fine motor skills that an 18-month-old child is not yet ready for. This activity is more appropriate for older children.

C. Colored paper and safety scissors could be a choking hazard for an 18-month-old child, and using scissors requires more advanced fine motor skills than most toddlers possess.

D. Alphabet flash cards are more suitable for older children, typically those who are 3 years and older, as they are better able to understand letters and begin to form associations with words.

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A nurse is contributing to the plan of care for an infant who has heart failure. Which of the following interventions should the nurse recommend?

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