A nurse is reinforcing teaching about food choices with a parent of a child who has celiac disease. Which of the following responses by the parent indicates an understanding of the teaching?

The correct answer is choice D, wooden building blocks.

Choice A rationale:

Colored paper and safety scissors are not appropriate for an 18-month-old child due to safety concerns. At this age, children are still developing fine motor skills and coordination, and the use of scissors, even safety ones, poses a risk of injury.

Choice B rationale:

Stringing beads is not suitable for an 18-month-old child as it requires more advanced fine motor skills and could pose a choking hazard. Children at this age are still prone to exploring objects by putting them in their mouths.

Choice C rationale:

Alphabet flash cards are not the best choice for an 18-month-old child with pneumonia. While flash cards can be educational, they are more suited for older children who are beginning to learn letters and words. At 18 months, play should focus on sensory and motor skill development rather than academic learning.

Choice D rationale:

Wooden building blocks are the most appropriate choice for an 18-month-old child. They encourage play that is developmentally supportive, promoting fine motor skills and creativity. Blocks can be easily handled by small hands, and there is no risk of injury or choking. Additionally, building and knocking down block towers can provide a sense of accomplishment and enjoyment for the child.

Choice A rationale:
Placing the infant in a supine position during naps might not be the best action for an infant with heart failure. In heart failure, infants often experience difficulty breathing due to fluid accumulation in the lungs. Placing the infant in a more upright position, such as semi-Fowler's, can help alleviate some of this respiratory distress.
Choice B rationale:
Feeding the infant a bottle every 4 hours is important, but it might not directly address the immediate concerns of an infant with heart failure. Infants with heart failure might have difficulty feeding due to fatigue and respiratory distress. Feeding smaller, more frequent meals and assessing the infant's feeding tolerance is crucial.
Choice C rationale:
Correct Answer. Documenting the infant's respiratory rate every 2 hours is an important action. Infants with heart failure often have respiratory distress and an increased respiratory rate, as the body tries to compensate for decreased cardiac output. Documenting the respiratory rate will help the healthcare team monitor the infant's condition and assess the effectiveness of interventions.
Choice D rationale:
Withholding digoxin if the infant's heart rate is greater than 100/min is not necessarily the correct action. Digoxin is a medication commonly used in heart failure to improve cardiac contractility. While it's important to monitor the infant's heart rate, a heart rate of greater than 100/min might be due to the body's compensatory mechanisms in response to heart failure. Withholding the medication without consulting a healthcare provider might not be appropriate.