A nurse is providing teaching to the parent of a newborn who has gastroesophageal reflux (GER). Which of the following instructions should the nurse include?
Dilute formula with 1 tablespoon of water.
Place the newborn in a side-lying position if vomiting.
Position the newborn at a 20-degree angle after feeding.
Provide a small feeding just before bedtime.
The Correct Answer is C
Choice A reason: Dilute formula with 1 tablespoon of water is not a correct instruction for GER. Diluting formula can reduce the nutritional value and increase the volume of the feedings, which can worsen GER symptoms and cause dehydration and malnutrition.
Choice B reason: Place the newborn in a side-lying position if vomiting is not a correct instruction for GER. This position can increase the risk of aspiration, which is the inhalation of vomit into the lungs. Aspiration can cause pneumonia, respiratory distress, and death.
Choice C reason: Position the newborn at a 20-degree angle after feeding is a correct instruction for GER. This position can help prevent reflux by using gravity to keep the stomach contents down. The newborn should be kept upright for at least 30 minutes after each feeding.
Choice D reason: Provide a small feeding just before bedtime is not a correct instruction for GER. This can increase the likelihood of reflux during sleep, as the stomach will be full and prone to regurgitation. The last feeding should be given at least 2 to 3 hours before bedtime.
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Related Questions
Correct Answer is D
Explanation
Choice A reason: A pump is usually needed to administer intermittent tube feedings, as it can control the flow rate and volume of the formula. A pump can also prevent overfeeding, aspiration, or diarrhea.
Choice B reason: Administering feedings over 10 to 20 minutes is too fast, as it can cause abdominal cramps, nausea, vomiting, or dumping syndrome. Intermittent tube feedings should be administered over 30 to 60 minutes.
Choice C reason: Administering feedings while sleeping at night is not recommended, as it can increase the risk of aspiration, reflux, or infection. Intermittent tube feedings should be administered during waking hours and with the head of the bed elevated at least 30 degrees.
Choice D reason: Advancing the rate of feedings slowly is advisable, as it can help the body adjust to the formula and prevent intolerance or complications. The rate should be increased gradually until the desired goal is reached.
Correct Answer is D
Explanation
Choice A reason: Increasing vitamin C intake while taking this medication is not necessary, as vitamin C does not interact with tetracycline. Vitamin C is important for immune function, wound healing, and collagen synthesis.
Choice B reason: Eliminating raw fruits and vegetables until 2 weeks after completing this medication is not required, as raw fruits and vegetables do not interfere with tetracycline. Raw fruits and vegetables are good sources of fiber, vitamins, minerals, and antioxidants.
Choice C reason: Taking a folic acid supplement while on this medication is not advised, as folic acid can reduce the absorption and effectiveness of tetracycline. Folic acid is essential for DNA synthesis, cell division, and red blood cell production.
Choice D reason: Avoiding taking this medication with milk products is important, as milk products contain calcium, which can bind to tetracycline and form insoluble complexes that decrease its absorption and activity. Milk products also increase the risk of gastrointestinal side effects such as nausea, vomiting, and diarrhea.
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