The nurse is providing nutrition education to the parents of an infant with failure to thrive (FTT). Which statement made by the parent should the nurse recognize as an appropriate understanding of interventions?
Breast milk provides adequate calories for the child.
Regular syringe feedings promote rapid weight gain.
High-calorie formula encourages increased growth.
Fruit juice increases the child's daily vitamin intake.
The Correct Answer is C
The nurse should recognize that the statement "high-calorie formula encourages increased growth" is an appropriate understanding of interventions for an infant with FTT. High-calorie formula can help infants who are not gaining weight adequately to increase their calorie intake and promote growth.
Breast milk provides adequate nutrition for most infants, but in cases of FTT, the infant may require a higher calorie intake than breast milk can provide. Regular syringe feedings and fruit juice are not recommended interventions for FTT. Syringe feedings can cause aspiration and fruit juice does not provide the appropriate balance of nutrients needed for an infant's growth and development.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend that the first dose of MMR vaccine be given at 12-15 months of age.
A. 6 months is too early for the MMR vaccine.
D. 2 months is also too early for the MMR vaccine.
C. 24 months is slightly beyond the recommended range for the first dose of MMR vaccine, which is given between 12-15 months of age.
Correct Answer is D
Explanation
A. Many infants with congenital heart defects exhibit audible murmurs due to turbulent blood flow through abnormal openings or stenotic valves. While a murmur is a diagnostic hallmark of the condition, it is often an expected finding and does not necessarily indicate acute physiological deterioration. The nurse must document the murmur, but it is rarely the most urgent finding to report.
B. A heart rate of 162 beats/minute in an infant is slightly elevated above the typical resting range but can be triggered by crying, feeding, or baseline cardiac stress from the defect. Although tachycardia requires close monitoring to ensure the infant is not entering a state of high-output failure, it is less critical than signs of fluid overload. It represents a compensatory mechanism rather than an immediate life-threatening complication.
C. Infants with cardiac defects often experience fatigue during feeding because of the high metabolic demand and decreased cardiac output. Poor suckling effort and inadequate oral intake are common symptoms of pediatric heart failure that lead to failure to thrive over time. While this finding is significant for long-term nutritional management, it does not suggest an acute, rapid shift in stability like sudden weight changes.
D. Rapid weight gain of 1 kg within 48 hours is the most critical finding because it indicates acute fluid volume excess and potential congestive heart failure. In an infant, such a significant increase is almost certainly due to fluid retention rather than nutritional growth. This clinical sign suggests that the heart is unable to manage the systemic or pulmonary circulation effectively, necessitating immediate medical intervention.
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