When caring for a child who has pertussis that is in the paroxysmal stage, which intervention should the nurse implement to support the child's nutritional needs?

• A. Provide small, frequent meals.
• B. Increase protein intake.
• C. Maintain a liquid diet.
• D. Offer the child a regular diet.

Answer: (A)

In the paroxysmal stage of pertussis, intense coughing spells wear the child out and can make eating, especially large meals, difficult or uncomfortable. Providing small, frequent meals allows the child to take in calories and fluids in manageable amounts, helps prevent fullness that could trigger coughing or vomiting, and supports better overall intake despite the energy drain from the illness. This approach also lowers the risk of aspiration during or after coughing fits and can be paired with feeding when the child is in a more comfortable part of a coughing cycle and positioned upright. Other options don’t specifically address the tolerance and safety of feeding during paroxysms: increasing protein isn’t targeted to the immediate problem, a liquid diet may not meet caloric needs, and offering a regular diet can overwhelm the child during episodes.