A nurse is providing teaching to the parents of a 6-month-old infant who is beginning to eat solid foods. The nurse should identify which of the following findings as an indication of an allergic reaction?
Fever
Jaundice
Bruising
Diarrhea
The Correct Answer is D
Choice A reason: Fever is not an indication of an allergic reaction, as it is a sign of infection or inflammation. The nurse should assess the infant for other causes of fever, such as ear infection, urinary tract infection, or viral illness.
Choice B reason: Jaundice is not an indication of an allergic reaction, as it is a sign of liver dysfunction or hemolysis. The nurse should evaluate the infant for other causes of jaundice, such as hepatitis, biliary atresia, or hemolytic anemia.
Choice C reason: Bruising is not an indication of an allergic reaction, as it is a sign of trauma or bleeding disorder. The nurse should examine the infant for other causes of bruising, such as injury, coagulopathy, or leukemia.
Choice D reason: Diarrhea is an indication of an allergic reaction, as it is a sign of gastrointestinal hypersensitivity or intolerance. The nurse should ask the parents about the infant's food intake, history of allergies, and symptoms of anaphylaxis, such as hives, swelling, or difficulty breathing.
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Correct Answer is D
Explanation
Choice D reason: A calorie reduction of 500 fewer calories per day can result in a weight loss of about 0.45 kg (1 lb) per week, which is a safe and realistic goal for most clients. A pound of fat contains about 3,500 calories, so reducing the daily intake by 500 calories can create a deficit of 3,500 calories per week.
Choice A reason: A weight loss of 0.45 kg (1 lb) per day is too rapid and unhealthy, as it can cause dehydration, electrolyte imbalance, muscle loss, and metabolic slowdown. It can also be unsustainable and lead to weight regain. A calorie reduction of 500 fewer calories per day cannot achieve such a drastic weight loss.
Choice B reason: A weight loss of 0.23 kg (0.5 lb) per day is also too rapid and unhealthy, for the same reasons as choice A. A calorie reduction of 500 fewer calories per day cannot achieve such a drastic weight loss.
Choice C reason: A weight loss of 0.23 kg (0.5 lb) per week is too slow and unlikely, as it would require a calorie reduction of only 250 fewer calories per day. This is not enough to create a significant deficit and stimulate weight loss. A calorie reduction of 500 fewer calories per day can result in a faster weight loss.
Correct Answer is A
Explanation
Choice A reason: Positioning the newborn at a 20-degree angle after feeding can help prevent the reflux of gastric contents into the esophagus. This position allows gravity to keep the food in the stomach and reduces the pressure on the lower esophageal sphincter. The nurse should instruct the parent to keep the newborn in this position for at least 30 minutes after each feeding.
Choice B reason: Diluting formula with 1 tablespoon of water is not recommended, as it can cause water intoxication, electrolyte imbalance, and malnutrition in the newborn. Water intoxication can lead to seizures, coma, and death. The nurse should advise the parent to follow the manufacturer's instructions for preparing the formula and not to add extra water.
Choice C reason: Placing the newborn in a side-lying position if vomiting is not a safe practice, as it can increase the risk of aspiration and sudden infant death syndrome (SIDS). Aspiration is when food or liquid enters the lungs and causes pneumonia or respiratory distress. SIDS is when a healthy baby dies suddenly and unexpectedly during sleep. The nurse should instruct the parent to place the newborn on the back for sleeping and to avoid soft bedding, pillows, and stuffed animals.
Choice D reason: Providing a small feeding just before bedtime is not a good idea, as it can worsen the gastroesophageal reflux and disrupt the newborn's sleep. The nurse should suggest the parent to feed the newborn smaller and more frequent meals throughout the day and to avoid feeding the newborn within 2 to 3 hours of bedtime.
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