A nurse is providing teaching to the parent of a newborn who has gastroesophageal reflux. Which of the following instructions should the nurse include?

"Provide a small feeding just before bedtime."

"Dilute formula with 1 tablespoon of water."

"Position the newborn at a 20-degree angle after feeding."

"Place the newborn in a side-lying position if vomiting."

Answer and Explanation

The Correct Answer is C

Gastroesophageal reflux (GER) is a common condition in infants where the contents of the stomach flow back into the esophagus. It often resolves on its own as the infant grows, but management strategies can help alleviate symptoms. Positioning the newborn upright or at a slight angle after feeding is a key recommendation to reduce reflux episodes.

Now, let's review the rationales for each option:

A) "Provide a small feeding just before bedtime." - Feeding a newborn just before bedtime can exacerbate reflux symptoms as lying down can increase the likelihood of stomach contents refluxing into the esophagus. Therefore, this instruction is not recommended as it may worsen GER symptoms.

B) "Dilute formula with 1 tablespoon of water." - Diluting formula with water can disrupt the balance of nutrients and calories in the formula, potentially affecting the infant's growth and nutritional status. Additionally, diluting formula does not address the underlying cause of GER and is not a recommended practice.

C) "Position the newborn at a 20-degree angle after feeding." - This instruction is correct. Placing the newborn at a 20-degree angle or slightly upright after feeding can help reduce the occurrence of reflux episodes by allowing gravity to assist in keeping stomach contents down. This position helps prevent the backflow of gastric contents into the esophagus and reduces discomfort for the infant.

D) "Place the newborn in a side-lying position if vomiting." - Placing the newborn in a side-lying position after vomiting may increase the risk of aspiration, especially in young infants. It is safer to position the infant upright or at a slight angle to minimize reflux and reduce the risk of aspiration.

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Correct Answer is D

Explanation

A) Breastfeeding alone cannot prevent a baby from developing phenylketonuria (PKU). PKU is an inherited metabolic disorder characterized by the body's inability to process phenylalanine, an amino acid found in protein. Infants with PKU must follow a special low-phenylalanine diet from birth to prevent intellectual disability and other complications. Breast milk contains phenylalanine, so infants with PKU require a special formula that is low in phenylalanine.

B) The consumption of diet sodas is not directly related to the management of phenylketonuria (PKU). Clients with PKU must closely monitor their intake of phenylalanine, an amino acid found in protein-containing foods. Diet sodas typically do not contain protein or phenylalanine, so their consumption is not a primary concern for individuals with PKU.

C) Monitoring serum bilirubin levels is not specific to the management of phenylketonuria (PKU) during pregnancy. Serum bilirubin levels are typically monitored to assess liver function and screen for conditions such as jaundice. While individuals with PKU may require additional monitoring during pregnancy, such as monitoring phenylalanine levels, serum bilirubin levels are not typically a focus of PKU management.

D) Following a low-protein diet for several months prior to conception is an important aspect of managing phenylketonuria (PKU) during pregnancy. High levels of phenylalanine in the mother's blood can cross the placenta and harm the developing fetus, potentially leading to intellectual disability and other complications. By adhering to a low-protein diet before conception, individuals with PKU can lower their phenylalanine levels and reduce the risk of complications during pregnancy.

A. Milk B. Eggs C. Citrus fruits D. Bananas

Correct Answer is ["A","B"]

Explanation

A) Milk and eggs are among the most common food allergens in toddlers. Cow's milk protein allergy is one of the most common food allergies in infancy and early childhood. It can cause a range of symptoms, including skin reactions, gastrointestinal symptoms, and respiratory issues. Similarly, egg allergy is also prevalent in toddlers and can manifest with symptoms such as skin reactions, gastrointestinal upset, and respiratory symptoms.

B) Eggs, like cow's milk, are common food allergens in toddlers. Egg allergy can present with various symptoms, including skin reactions like hives, digestive symptoms such as abdominal pain or diarrhea, and respiratory symptoms like wheezing or nasal congestion.

C) Citrus fruits are less commonly associated with allergies compared to milk and eggs. While citrus fruits can cause allergic reactions in some individuals, they are not typically among the top allergens in toddlers.

D) Bananas are also not among the most common food allergens in toddlers. While it is possible for individuals to be allergic to bananas, such allergies are less prevalent compared to milk and egg allergies.

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A nurse is providing teaching to the parent of a newborn who has gastroesophageal reflux. Which of the following instructions should the nurse include?

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