A nurse is planning care for an 8-month-old infant who has heart failure. Which of the following actions should the nurse include in the plan of care?

A. "Check the pH of the gastric secretions."Checking the pH of the gastric secretions is crucial to confirm that the NG tube is correctly positioned in the stomach. This helps ensure that the tube is in the right place before administering the feeding, thereby reducing the risk of complications such as aspiration.

B. "Attach the feeding bag tubing to the end of the NG tube."Attaching the feeding bag tubing should be done after verifying the tube's placement and ensuring it is in the stomach. This step is important, but it follows confirmation of correct tube placement.

C. "Flush the tube with water."Flushing the tube with water is important to ensure patency and prepare the tube for feeding. However, this should only be done after confirming the tube's placement.

D. "Set the administration rate on the feeding pump."Setting the administration rate is necessary for administering the feeding but should be done after confirming tube placement and preparing the tube.

Choice A Reason:

Placing the infant in a prone position might not be suitable for an infant with heart failure. Typically, an upright or semi-upright position can help reduce the workload on the heart by improving respiratory function and aiding in cardiac output.

Choice B Reason:

Repeating a digoxin dosage if the infant vomits within 1 hour of administration isn't recommended without consulting a healthcare provider. If vomiting occurs within this time frame, giving another dose might result in overdosing.

Choice C Reason:

Administering cool, humidified oxygen via nasal cannula can be beneficial for an infant with heart failure, as it helps in providing supplemental oxygen and maintaining adequate oxygenation levels.

Choice D Reason:

Providing less frequent, higher volume feedings might not be appropriate for an infant with heart failure. These infants often require smaller, more frequent feedings to prevent overloading the digestive system and to manage fluid intake.