At a well-child check-up, the nurse notes that an infant with a previous diagnosis of failure to thrive (FTT) is now steadily gaining weight. The nurse should recommend that fruit juice intake be limited to no more than how much?

Correct Answer: A

Rationale: In the case of an infant with a history of failure to thrive (FTT) who is now gaining weight steadily, limiting fruit juice intake to no more than 4 oz/day is crucial. Infants with FTT are at risk for poor weight gain and excessive fruit juice consumption can displace more nutrient-dense foods, leading to inadequate caloric intake. Option A (4 oz/day) is the correct choice because the American Academy of Pediatrics recommends limiting fruit juice intake for infants to prevent excessive calorie intake and potential dental issues. Options B, C, and D are incorrect as they exceed the recommended daily limit for fruit juice intake in infants. Providing more than 4 oz/day of juice can lead to increased sugar consumption, which may contribute to obesity and other health concerns in infants. From an educational perspective, it is important for nurses to understand the specific dietary recommendations for infants with FTT to support their growth and development appropriately. By limiting fruit juice intake and focusing on nutrient-rich foods, nurses can help promote healthy weight gain and overall well-being in these vulnerable infants.

Correct Answer: A

Rationale: The correct answer is A) Encourage the parent to verbalize feelings. This is the best action because it demonstrates therapeutic communication, empathy, and support for the parent's emotional well-being. By encouraging the parent to express their feelings, the nurse can help validate their emotions, reduce stress, and foster a trusting relationship. Option B) Encouraging the parent not to worry so much is dismissive and does not address the parent's emotional needs or the challenges they are facing with a colicky infant. Option C) Assessing the parent for other signs of inadequate parenting is presumptive and may create unnecessary stress or guilt for the parent. It is important to approach the situation with empathy and support rather than suspicion. Option D) Reassuring the parent that colic rarely lasts past age 9 months is informative but does not address the parent's current distress or offer emotional support. It is crucial to prioritize the parent's emotional well-being and provide a supportive environment for them to express their feelings and concerns. In an educational context, this question highlights the importance of therapeutic communication skills in pediatric nursing. Nurses must be able to support and empathize with parents who may be experiencing stress or emotional challenges related to their child's health. Encouraging open communication and active listening can help build trust and rapport with parents, leading to better outcomes for both the child and the family.

Correct Answer: C

Rationale: In the context of nursing care of children, it is crucial to understand the clinical manifestations of failure to thrive (FTT) to provide appropriate care. In this scenario, the correct answer is C) Weight that is at or below the 10th percentile. This is because FTT is characterized by inadequate weight gain or inappropriate weight loss in children, leading to their weight falling below the expected range for their age. This can be a result of various factors such as inadequate caloric intake, underlying medical conditions, or poor feeding practices. Option A) Irregularity in activities of daily living is incorrect as it does not directly relate to the typical clinical manifestation of FTT, which is primarily centered around growth parameters. Option B) Preferring solid food to milk or formula is also incorrect as it may indicate a preference in food texture but is not a specific clinical manifestation of FTT. Option D) Appropriate achievement of developmental landmarks is incorrect because while FTT can impact development, the primary clinical manifestation is related to weight and growth parameters falling below expected percentiles. Educationally, understanding the signs and symptoms of FTT is essential for early identification and intervention to prevent further complications in children's health. Nurses need to be able to recognize these manifestations to collaborate with the healthcare team in developing a comprehensive care plan to address the underlying causes of FTT and promote optimal growth and development in children.

Correct Answer: B

Rationale: In the context of an infant with failure to thrive (FTT), the recommended strategy to increase caloric intake is option B) Be persistent through 10 to 15 minutes of food refusal. This approach is appropriate because infants with FTT often have feeding difficulties, and it is important for caregivers to persist through initial food refusal to ensure the infant receives adequate nutrition. Option A) Vary the schedule for routine activities on a daily basis is incorrect because while routine and structure are important for infants, varying the schedule may not specifically address the issue of increasing caloric intake for an infant with FTT. Option C) Avoid solids until after the bottle is well accepted is incorrect because delaying the introduction of solids may not address the immediate need to increase caloric intake in infants with FTT. Option D) Use developmental stimulation by a specialist during feedings is incorrect because while developmental stimulation is important for overall infant development, it may not directly impact caloric intake for an infant with FTT. Educationally, it is crucial for nursing students to understand the unique challenges and interventions involved in caring for infants with FTT. By recognizing the appropriate strategies to address feeding difficulties in these infants, nurses can play a vital role in promoting optimal growth and development in this vulnerable population.

Correct Answer: A

Rationale: In this scenario, option A is the correct answer that indicates the need for additional teaching by the nurse. Letting the infant cry for at least 30 minutes before responding is not an appropriate or effective way to manage colic in a 2-month-old baby. Crying is the only way infants can communicate their needs, and leaving them to cry can lead to increased distress. Option B, swaddling the infant tightly with a soft blanket, is a recommended practice as it can provide comfort and a sense of security to the baby. Option C, massaging the infant's abdomen, can help relieve colic symptoms by aiding in digestion and providing soothing touch. Option D, placing the infant in an upright seat after feeding, can also be beneficial in reducing colic symptoms by minimizing reflux and gas. Educationally, it is important for parents to understand appropriate ways to address colic in infants to provide comfort and support. Teaching parents effective strategies such as swaddling, infant massage, and positioning after feeding can help them better care for their colicky baby and strengthen the parent-child bond. Encouraging responsive and nurturing care is key in managing colic and promoting the overall well-being of the infant.