A parent of an infant with diaper dermatitis is being taught by a nurse. Which of the following instructions should the nurse include?

Correct Answer: B

Rationale: In pediatric nursing, providing education to parents is crucial for the proper care of their children. In the case of diaper dermatitis, the correct instruction for the nurse to include is option B: Expose the baby's skin to air. This is because allowing the baby's skin to be exposed to air helps in promoting healing and preventing further irritation by keeping the area dry and reducing moisture which can exacerbate the dermatitis. Option A is incorrect as using baby wipes that contain alcohol can further irritate the baby's sensitive skin and worsen the dermatitis. Option C is also wrong as using a blow dryer on the warm setting can be too harsh on the baby's delicate skin and may cause further irritation. Option D, giving the baby a bath once a week, is not the best instruction for diaper dermatitis. Frequent bathing can strip the skin of its natural oils and disrupt the skin barrier, making it more susceptible to irritation. Educational context should emphasize the importance of gentle skin care practices, keeping the diaper area clean and dry, and using barrier creams to protect the skin. Encouraging open communication with healthcare providers for ongoing support and guidance is also essential for parents caring for infants with dermatitis.

Correct Answer: C

Rationale: In pediatric nursing, it is crucial to educate adolescents on preventive measures for urinary tract infections (UTIs). The best beverage to recommend to maintain acidic urine, thereby preventing UTIs, is apple juice (Option C). Apple juice contains ascorbic acid, which can help acidify urine and create an environment less conducive to bacterial growth, reducing the risk of UTIs. Milk (Option A) is not recommended as it can make the urine less acidic due to its calcium content. Grape juice (Option B) and orange juice (Option D) are also acidic, but they are not as effective as apple juice in acidifying the urine. Educating adolescents on the importance of maintaining proper hydration and consuming specific beverages can empower them to take control of their health and prevent common issues like UTIs. By explaining the rationale behind recommending apple juice over other options, healthcare providers can help adolescents make informed choices about their dietary habits and promote preventive healthcare practices. This educational context ensures that adolescents understand the reasoning behind the recommendations and can apply this knowledge to maintain their urinary health effectively.

Correct Answer: B

Rationale: In nephrotic syndrome, edema is a common symptom that is generalized and not easily noticeable, even by parents. However, an early sign that can be assessed by the nurse is periorbital edema, which refers to swelling around the eyes. This can be an initial indicator of nephrosis and may prompt further evaluation and intervention.

Correct Answer: D

Rationale: Rationale: The correct answer is D) Should be delayed. Prednisone, a corticosteroid, suppresses the immune system, reducing the body's ability to mount a proper response to vaccines. Administering live vaccines such as MMR or varicella to a child on prednisone can lead to an inadequate immune response and potential vaccine failure. Therefore, it is recommended to delay live vaccines until the child has completed the course of prednisone and their immune system has recovered. Option A) Can interfere with the treatment for nephrosis is incorrect because receiving immunizations while on prednisone does not directly interfere with the treatment of nephrotic syndrome. It is more about the effectiveness of the vaccines themselves. Option B) Require that the child have antibiotic coverage is incorrect as antibiotics are not typically needed when delaying vaccinations due to corticosteroid use. Option C) Can be given in smaller, divided doses is incorrect because the issue with prednisone and immunizations is not about the dose size but rather the compromised immune response while on prednisone. In an educational context, understanding the impact of corticosteroids on the immune system and vaccination efficacy is crucial for pediatric nurses to provide safe and effective care to children with chronic conditions like nephrotic syndrome. Delaying vaccines until the child is off prednisone allows for better protection against vaccine-preventable diseases.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Kidney stones. The ketogenic diet, which is high in fats and low in carbohydrates, can lead to an increased risk of kidney stone formation due to several factors. Firstly, the diet can result in a low urine pH, which promotes the formation of certain types of kidney stones. Additionally, the diet may lead to dehydration and reduced urinary citrate levels, further contributing to stone formation. Children on a ketogenic diet should maintain adequate fluid intake to prevent kidney stone development. Regarding the incorrect options: A) Appendicitis: Appendicitis is not directly related to the ketogenic diet. The symptoms of appendicitis typically include right lower quadrant abdominal pain, not left-sided pain as described in the scenario. B) Bowel obstruction: Bowel obstruction is also not a common complication of the ketogenic diet. Symptoms of bowel obstruction would include abdominal distention, vomiting, and constipation, rather than left-sided pain. C) Urinary tract infection: While urinary tract infections can occur in children, the left-sided pain described in the scenario is not a typical presentation of a UTI. UTIs usually present with symptoms such as urinary urgency, frequency, and dysuria. Educationally, this question highlights the importance of understanding the potential complications associated with specific treatments, such as the ketogenic diet in children with seizures. Nurses caring for pediatric patients on this diet need to be vigilant for signs and symptoms of kidney stones and educate both the child and their caregivers on preventive measures such as adequate hydration and monitoring for symptoms of kidney stones.