What suggestion should the nurse provide to prevent diaper rash in a 4-month-old infant as requested by the mother?

Correct Answer: C

Rationale: Using a barrier cream like zinc oxide forms a protective layer on the skin, creating a barrier against irritants and moisture, thus helping to prevent diaper rash. Unlike other options, barrier creams do not need to be completely removed at each diaper change, allowing the skin to remain protected between changes.

Correct Answer: D

Rationale: The most crucial information for the nurse to obtain in this scenario is how often the metered-dose inhaler (MDI) is used daily. This information will help assess if the symptoms of insomnia, shakiness, and palpitations are potentially related to overuse of the inhaler, which can cause side effects such as tremors and palpitations. Monitoring the frequency of MDI usage is essential in managing asthma and ensuring appropriate medication administration.

Correct Answer: B

Rationale: Administering the scheduled dose is appropriate in this scenario since the heart rate of 128 bpm is within an acceptable range for a 2-year-old child with heart failure. Monitoring for signs of digoxin toxicity is important; however, the immediate action required is to administer the scheduled dose as prescribed based on the heart rate assessment.

Correct Answer: D

Rationale: The most important information for the nurse to obtain in this scenario is how often the albuterol metered-dose inhaler (MDI) is used daily (Option D). This is crucial because the symptoms described by the student - difficulty sleeping, shakiness, and rapid heart rate - could be indicative of overuse of the albuterol inhaler, which can lead to potential side effects like tachycardia and tremors. Option A, asking when she last took the antihistamine, is less relevant as antihistamines are not typically associated with the symptoms described. Option B, inquiring about the last asthma attack, while important, is not as urgent as determining the frequency of albuterol MDI use in this case. Option C, asking about the duration of most asthma attacks, is also less critical than understanding the frequency of albuterol inhaler use. Educationally, this question highlights the importance of assessing medication usage and potential side effects in pediatric patients with asthma. It emphasizes the need for healthcare providers to consider medication adherence and proper dosing to prevent adverse reactions and ensure optimal asthma management.

Correct Answer: C

Rationale: In this scenario, the correct answer is option C: Use a barrier cream, such as zinc oxide, which does not have to be completely removed with each diaper change. This recommendation is appropriate because barrier creams create a protective layer on the skin, preventing irritation from moisture and friction. Zinc oxide specifically has soothing and healing properties, aiding in preventing and treating diaper rash. Additionally, not having to remove the cream completely at each change reduces skin irritation from frequent wiping. Option A is incorrect because talcum powder can actually lead to respiratory issues when inhaled by the baby and does not provide a barrier to moisture. Option B suggests using soap and water every 2 hours, which can strip the skin of natural oils and cause further irritation. Option D is unnecessary and can increase the risk of overheating and discomfort for the baby due to the added bulk of the cloth diaper. In a pediatric nursing context, it is crucial to educate parents on proper diaper care to prevent common issues like diaper rash. Teaching about barrier creams and their benefits, along with proper hygiene practices, helps parents maintain their baby's skin health and comfort.