In providing anticipatory guidance to the mother of a two-month old breast-fed infant, which of the following should the nurse include:

Choice A reason: This is incorrect because the symptoms described by the mother are not typical of a formula allergy. A formula allergy would cause symptoms such as rash, hives, wheezing, or vomiting within minutes or hours of feeding. Switching to a soy based formula is not recommended without consulting a doctor, as some infants may also be allergic to soy.

Choice B reason: This is incorrect because feeding the infant after vomiting and diarrhea may worsen the condition and cause more dehydration. The infant should be given small amounts of oral rehydration solution (ORS) or breastmilk to prevent fluid loss. If the infant cannot tolerate oral fluids or shows signs of severe dehydration, such as sunken eyes, dry mouth, or lethargy, they should be taken to the emergency department for intravenous rehydration.

Choice C reason: This is incorrect because blood and mucous in the stool are not normal findings in infants and should be investigated promptly. They may indicate a serious condition such as intussusception, which is a telescoping of the bowel that causes obstruction and inflammation. The stool may look like currant jelly due to the presence of blood and mucous. Intussusception is a medical emergency that requires immediate treatment.

Choice D reason: This is correct because the infant's symptoms may indicate a serious condition such as intussusception, which can be life-threatening if left untreated. The infant should be taken to the emergency room for further evaluation and management. The nurse should also advise the mother to monitor the infant's vital signs, hydration status, and urine output until they reach the hospital.

Choice A reason: This is not a good choice. Delaying dental visits until the child's heart defect is fully repaired is not a recommended practice. Dental hygiene is important for preventing oral infections that can spread to the bloodstream and cause infective endocarditis. The child should have regular dental check-ups and cleanings, as well as good oral care at home.

Choice B reason: This is the correct choice. Administration of antibiotics one hour prior to all dental procedures is a critical teaching point to emphasize for parents of a child with a complex congenital heart defect. Dental procedures can cause bleeding and bacteria to enter the bloodstream, which can infect the damaged or abnormal heart valves and cause infective endocarditis. Antibiotics can prevent or reduce the risk of this complication by killing the bacteria before they reach the heart.

Choice C reason: This is not a good choice. Administration of daily prophylactic antibiotics is not a necessary or effective measure for preventing infective endocarditis in a child with a complex congenital heart defect. Daily antibiotics can cause side effects, such as allergic reactions, diarrhea, or yeast infections. They can also lead to antibiotic resistance, which can make the bacteria harder to treat if they do cause an infection.

Choice D reason: This is not a good choice. High dose IV antibiotics for 2-8 weeks is not a preventive strategy for infective endocarditis, but a treatment option for an established infection. IV antibiotics are given to eradicate the bacteria from the bloodstream and the heart valves and prevent further damage or complications. However, IV antibiotics are not always effective and may have serious s