A nurse is providing teaching to the parent of an infant who has gastroesophageal reflux. Which of the following statements by the parent indicates an understanding of the teaching?

A patent ductus arteriosus (PDA) is a congenital heart defect associated with increased pulmonary blood flow. In normal fetal circulation, the ductus arteriosus allows blood to bypass the lungs since the baby receives oxygen from the mother's placenta. After birth, the ductus arteriosus should close, redirecting blood flow to the lungs for oxygenation. However, in some infants with PDA, the ductus arteriosus remains open, causing an abnormal connection between the aorta and the pulmonary artery. As a result, oxygenated blood from the aorta flows back into the pulmonary artery, increasing the workload on the lungs.

The other options are as follows:
A. Coarctation of the aorta - Coarctation of the aorta is a narrowing of the aorta, which obstructs blood flow and leads to increased blood pressure in the upper body and reduced blood flow to the lower body.
C. Tetralogy of Fallot - Tetralogy of Fallot is a combination of four heart defects that results in decreased pulmonary blood flow due to a ventricular septal defect (VSD), overriding aorta, pulmonary stenosis, and right ventricular hypertrophy.
D. Tricuspid atresia - Tricuspid atresia is a congenital heart defect where the tricuspid valve does not develop correctly, resulting in an absent or abnormal tricuspid valve. This defect prevents blood flow from the right atrium to the right ventricle and, therefore, reduces pulmonary blood flow.

Children with sickle cell anemia are prone to dehydration, which can worsen the sickling of red blood cells and trigger a sickle cell crisis. Therefore, it is essential to maintain good hydration to prevent crises. Offering fluids to the child multiple times every day helps to keep them well-hydrated.
Option B is not necessary unless there is a specific medical reason to restrict outdoor play. Regular play is essential for a child's physical and emotional development.
Option C is important, but it is not specific to discharge teaching after an acute crisis episode. Monitoring the child's temperature daily is essential to detect early signs of infection, which can be a trigger for sickle cell crises.
Option D is not recommended because applying cold compresses can cause vasoconstriction and may worsen pain in children with sickle cell anemia. Heat therapy, warm compresses, or a warm bath are more appropriate for pain relief during a sickle cell crisis. However, pain management should be discussed with the healthcare provider to ensure the most appropriate approach for the individual child's needs.