A nurse is teaching a client who has bradycardia about how to prevent vagal stimulation. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

A. Position the newborn on their abdomen after feeding: Placing a newborn on their abdomen after feeding increases the risk of aspiration and sudden infant death syndrome (SIDS). The recommended position after feeding is upright or on their back when sleeping.

B. Place the newborn on a rigid feeding schedule: Strict feeding schedules can lead to overfeeding or underfeeding, both of which can increase spit-up. Feeding on demand or according to the newborn’s hunger cues is safer and helps minimize gastrointestinal discomfort.

C. Offer the newborn a pacifier after feedings: Using a pacifier may soothe the newborn but does not reduce the incidence of spit-up. It is unrelated to gastric emptying or swallowing air during feeding.

D. Burp the newborn several times during the feeding: Frequent burping helps release swallowed air, which can decrease gastric distention and reduce spit-up. This technique is an effective intervention to minimize discomfort and regurgitation in formula-fed newborns.

A. Instill normal saline drops to nares before meals: Saline drops are used to loosen nasal secretions in conditions like the common cold or bronchiolitis. They do not address epiglottitis and are not a primary intervention for this life-threatening airway condition.

B. Perform chest percussion and postural drainage twice per day: Chest physiotherapy is indicated for conditions with increased pulmonary secretions, such as cystic fibrosis or pneumonia. Epiglottitis primarily affects the upper airway, so these interventions are not appropriate.

C. Initiate droplet precautions: Epiglottitis is often caused by Haemophilus influenzae type b and can be transmitted via respiratory droplets. Implementing droplet precautions protects healthcare workers and other clients from infection while the child receives care.

D. Administer pancreatic enzymes with meals: Pancreatic enzyme replacement is used in conditions like cystic fibrosis to aid digestion. It is unrelated to epiglottitis and does not address the acute respiratory risk posed by airway inflammation.