A parent of a child with attention deficit hyperactivity disorder (ADHD) is being taught by a nurse. Which instruction should the nurse include in the teaching?

Correct Answer: D

Rationale: In pediatric nursing, educating parents of children with ADHD is crucial for effective management. The correct answer, option D - Maintain a consistent bedtime routine, is essential in managing ADHD. Consistency in bedtime routines helps regulate the child's sleep patterns, which can positively impact their behavior and attention span. Option A is incorrect because administering methylphenidate at bedtime can disrupt the child's sleep, leading to further behavioral issues. Option B suggesting increasing stimuli is counterproductive as children with ADHD often benefit from a structured and low-stimulus environment to help them focus. Option C of giving an extra dose of medication if the child is overactive is not safe and can lead to potential overdose or adverse effects. Educationally, teaching parents about the importance of consistency, structure, and routines in managing ADHD provides them with practical strategies to support their child's well-being and behavior. This instruction empowers parents to create a stable environment that can positively impact their child's ADHD symptoms and overall quality of life.

Correct Answer: D

Rationale: In caring for a child with Wilms' tumor scheduled for surgery, the nurse should include avoiding palpating the abdomen in the plan of care. The correct answer, option D, is essential to prevent the risk of tumor rupture and dissemination of cancer cells. Palpation can potentially lead to seeding of tumor cells into adjacent tissues or blood vessels, increasing the risk of metastasis. Repositioning the child frequently, as in option B, is a general care measure to prevent pressure ulcers but is not directly related to the child's condition or surgery. Option A, palpating the abdomen daily for tumor size, is contraindicated as it can cause harm as mentioned earlier. Option C, preparing the child for chemotherapy, is also incorrect as the child is scheduled for surgery, not chemotherapy. In a pediatric nursing context, it is crucial to prioritize interventions that promote the well-being and safety of the child. Understanding the specific needs of a child with Wilms' tumor, such as the risk of tumor manipulation, guides the nurse in providing safe and effective care. By selecting option D, the nurse ensures that the care plan aligns with best practices and minimizes potential complications for the child undergoing surgery for Wilms' tumor.

Correct Answer: D

Rationale: When caring for an infant with a colostomy, it is essential to apply barrier ointment to the skin around the stoma. This helps in preventing skin breakdown and irritation caused by exposure to stool or urine. Changing the ostomy pouch as needed, using appropriate cleaning supplies such as warm water and mild soap (avoiding harsh chemicals like alcohol), and ensuring gentle cleaning of the stoma with a soft cloth or gauze are also important steps in colostomy care. Using baby wipes may not be recommended as they can contain chemicals that may irritate the sensitive skin around the stoma.

Correct Answer: D

Rationale: The correct instruction for a child with contact dermatitis is to apply a thin layer of corticosteroid cream to the affected area. Corticosteroid cream helps reduce inflammation and itching associated with contact dermatitis. It is important to avoid using antibiotic ointment or rubbing the skin vigorously, as these can worsen the condition. Keeping the child's skin dry is generally a good practice, but in the case of contact dermatitis, corticosteroid cream application is more beneficial.

Correct Answer: B

Rationale: Changing the child's position frequently is essential for preventing respiratory tract infections and reducing pressure on delicate skin, which are common risks for edematous children with reduced mobility due to nephrotic syndrome. This intervention helps promote circulation and prevents complications associated with prolonged immobility.