A nurse is teaching a parent about appropriate snack choices for her 9-month-old infant. Which of the following food choices should the nurse recommend?

Choice A reason: Dilute formula with 1 tablespoon of water is not a correct instruction for GER. Diluting formula can reduce the nutritional value and increase the volume of the feedings, which can worsen GER symptoms and cause dehydration and malnutrition.

Choice B reason: Place the newborn in a side-lying position if vomiting is not a correct instruction for GER. This position can increase the risk of aspiration, which is the inhalation of vomit into the lungs. Aspiration can cause pneumonia, respiratory distress, and death.

Choice C reason: Position the newborn at a 20-degree angle after feeding is a correct instruction for GER. This position can help prevent reflux by using gravity to keep the stomach contents down. The newborn should be kept upright for at least 30 minutes after each feeding.

Choice D reason: Provide a small feeding just before bedtime is not a correct instruction for GER. This can increase the likelihood of reflux during sleep, as the stomach will be full and prone to regurgitation. The last feeding should be given at least 2 to 3 hours before bedtime.

Choice A reason: Recommending a total fiber intake of 12 g each day is not an appropriate action for the nurse to take because it is too low for most adults. The recommended dietary allowance (RDA. for fiber is 25 g per day for women and 38 g per day for men, which can help lower cholesterol, regulate blood sugar, and promote bowel health.

Choice B reason: Referring the client to a weight-loss support group is an appropriate action for the nurse to take because it can help the client achieve and maintain a healthy weight. A body mass index (BMI) of 28 indicates overweight, which can increase the risk of chronic diseases, such as diabetes, hypertension, and cardiovascular disease. A weight-loss support group can provide education, motivation, and accountability for the client.

Choice C reason: Advising the client to add 500 calories per day to the diet is not an appropriate action for the nurse to take because it can lead to weight gain. A client who has a BMI of 28 does not need to increase their caloric intake unless they have other medical conditions or nutritional needs that require more calories. Adding 500 calories per day to the diet can result in gaining about one pound per week, which can worsen the health outcomes of the client.

Choice D reason: Encouraging the client to continue current daily caloric intake is not an appropriate action for the nurse to take because it may prevent weight loss. A client who has a BMI of 28 needs to reduce their caloric intake by 500 to 1,000 calories per day to lose one to two pounds per week, which is considered a safe and effective rate of weight loss.