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?

Choice A reason: Scrambled eggs are a good food choice for a client who has difficulty chewing due to ill-fitting dentures because they are soft, moist, and easy to swallow. Scrambled eggs also provide protein, iron, and vitamin B12 for the client.

Choice B reason: Tuna fish is not a good food choice for a client who has difficulty chewing due to ill-fitting dentures because it may contain bones, skin, or scales that can cause discomfort or injury to the gums or mouth. Tuna fish should be avoided or checked for bones and skin before consuming.

Choice C reason: Roast beef is not a good food choice for a client who has difficulty chewing due to ill-fitting dentures because it is tough, dry, and hard to chew. Roast beef can cause pain, fatigue, or choking for the client who has ill-fitting dentures. Roast beef should be avoided or cut into very small pieces and moistened with gravy or sauce before consuming.

Choice D reason: Apple slices are not a good food choice for a client who has difficulty chewing due to ill-fitting dentures because they are crisp, firm, and sticky. Apple slices can dislodge or damage the dentures or cause irritation or infection to the gums or mouth. Apple slices should be avoided or cooked until soft and mashed before consuming.

Choice E reason: Dried fruit is not a good food choice for a client who has difficulty chewing due to ill-fitting dentures because they are chewy, sticky, and sugary. Dried fruit can adhere to the dentures or teeth and cause dental caries or gum disease. Dried fruit should be avoided or soaked in water until soft and cut into small pieces before consuming.

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.