A nurse is caring for an infant who has heart failure and is formula-fed. Which of the following nursing interventions is appropriate to meet the infant's nutritional needs?

A. Use a firm nipple on the bottle is incorrect. A firm nipple can cause the infant to exert more energy while feeding, which can exacerbate fatigue in an infant with heart failure. A soft or medium nipple is generally recommended to minimize energy expenditure. B. Thicken the formula with a tsp of rice cereal per ounce is incorrect. Thickeners like rice cereal are not recommended for infants with heart failure, as they can increase the caloric intake and make digestion more difficult, potentially worsening the condition. C. Dilute the formula with water to half strength is incorrect. Diluting formula with water can reduce the calorie and nutrient content, which is not appropriate for an infant who needs adequate nutrition to support growth and health, especially when dealing with heart failure. D. Feed the infant at the first sign of hunger is correct. Feeding the infant at the first sign of hunger is important because it allows for smaller, more frequent meals that can reduce the workload on the heart. This approach helps prevent fatigue and improves the infant's ability to consume the necessary calories and nutrients.