A nurse is updating a plan of care for a client who has a new prescription for a calorie count. Which of the following interventions should the nurse Include?

A. Offer the client a selection of beverages at each meal: Providing a variety of beverages may offer hydration and a sense of control, but clients with anorexia nervosa often use fluids to avoid calorie-dense solid foods. This approach can reinforce avoidance behaviors and does not contribute meaningfully to nutritional rehabilitation or psychological recovery.
B. Inform the client that a weight gain of 2.3 kg (5 lb) per week is expected: A weight gain goal of 2.3 kg per week is too aggressive and may provoke anxiety or resistance from the client. A slower, more gradual goal of 0.5 to 1 kg (1 to 2 lb) per week is considered safer and more psychologically tolerable. Unrealistic expectations can harm rapport and may lead to nonadherence or relapse.
C. Arrange for someone to remain with the client for 30 min after meals: Monitoring after meals is essential to prevent purging or other compensatory behaviors. The standard is 60 to 90 minutes post-meal observation to address delayed attempts at purging or exercising. Thus, while well-intentioned, this time frame is insufficient.
D. Encourage the client to participate in developing dietary goals: Involving the client in setting dietary goals promotes a sense of autonomy, collaboration, and ownership in the recovery process. This approach is therapeutic, reduces power struggles, and helps build trust between the nurse and the client.

A. Feedings should begin within 1 hr after birth. Initiating feeding within the first hour of life supports early bonding and helps stabilize the newborn’s blood glucose. This applies to both breastfed and bottle-fed infants and is considered a key component of newborn care.
B. Feedings can be controlled by gravity. Bottle feedings should not rely solely on gravity, as this can increase the risk of overfeeding and aspiration. Instead, caregivers should hold the bottle at an angle and watch for feeding cues, allowing the infant to suck and swallow at their own pace.
C. Feedings should be on demand. While on-demand feeding is typically encouraged with breastfeeding, bottle feeding is generally guided by scheduled intervals (e.g., every 3–4 hours) early on. Over time, bottle-fed infants may show hunger cues, but structured timing helps regulate intake initially.
D. Feedings may occur in clusters. Cluster feeding is common with breastfeeding due to variable milk flow and infant comfort needs. Bottle-fed infants usually have more consistent feeding patterns and are less likely to feed in unpredictable clusters.