In preparing for home oral feeding for a ventilator-dependent child, which sequence of actions should the nurse take?

In preparing for home oral feeding for a ventilator-dependent child, which sequence of actions should the nurse take?

• A. Acknowledge the request and explore options; 2. Set additional feeding goals with family; 3. Refuse to feed orally; 4. Ask parents to negotiate changes with the provider
• B. Acknowledge the request; 2. Refuse to feed orally; 3. Set goals; 4. Explore options
• C. Refuse to feed orally; 2. Acknowledge request; 3. Set goals; 4. Explore options
• D. Explore options; 2. Acknowledge request; 3. Set goals; 4. Refuse to feed orally

Answer: (A)

Collaborative, family-centered planning that emphasizes safety and clear communication is being tested. When a ventilator-dependent child’s family requests home oral feeding, the nurse should first acknowledge the request and invite discussion about possible options, so the family feels heard and understands what might be feasible. This sets a trusting foundation for decision making. Then it’s important to work with the family to set meaningful feeding goals together—clarifying what is hoped to be achieved, what safety considerations exist, and what alternatives might be appropriate. Establishing these goals with the family helps align expectations and creates a concrete plan to move forward. If after exploring options and agreeing on goals oral feeding isn’t suitable, it’s appropriate to explain the reasons clearly and proceed with a safety-focused plan, which may involve not feeding orally at this time. This maintains safety while still supporting the family’s involvement in care decisions. Finally, guiding the parents to discuss any requested changes with the provider ensures coordination with the healthcare team and keeps the plan consistent with medical guidance. Other approaches skip essential steps—starting with refusal without exploring options, or omitting joint goal setting, or pushing changes to the provider without first involving the family—and they don’t support collaborative, safe decision making.

Collaborative, family-centered planning that emphasizes safety and clear communication is being tested. When a ventilator-dependent child’s family requests home oral feeding, the nurse should first acknowledge the request and invite discussion about possible options, so the family feels heard and understands what might be feasible. This sets a trusting foundation for decision making. Then it’s important to work with the family to set meaningful feeding goals together—clarifying what is hoped to be achieved, what safety considerations exist, and what alternatives might be appropriate. Establishing these goals with the family helps align expectations and creates a concrete plan to move forward.

If after exploring options and agreeing on goals oral feeding isn’t suitable, it’s appropriate to explain the reasons clearly and proceed with a safety-focused plan, which may involve not feeding orally at this time. This maintains safety while still supporting the family’s involvement in care decisions. Finally, guiding the parents to discuss any requested changes with the provider ensures coordination with the healthcare team and keeps the plan consistent with medical guidance.

Other approaches skip essential steps—starting with refusal without exploring options, or omitting joint goal setting, or pushing changes to the provider without first involving the family—and they don’t support collaborative, safe decision making.