A 14-year-old girl has returned to the nursing unit after undergoing an appendectomy. To help relieve pain and facilitate drainage, the nurse should place her in what position?

Choice A reason: This is not the correct order, as obtaining blood cultures should be done after starting high dose antibiotics, not before. This is because antibiotics can interfere with the detection of bacteria in the blood and affect the accuracy of the diagnosis¹.

Choice B reason: This is not the correct order, as administering high dose steroids is not indicated for infective endocarditis, unless there is evidence of severe inflammation or allergic reaction. Steroids can suppress the immune system and increase the risk of infection².

Choice C reason: This is not the correct order, as starting the child on high dose aspirin is not recommended for infective endocarditis, unless there is evidence of thromboembolic complications or Kawasaki disease. Aspirin can increase the risk of bleeding and interfere with the action of antibiotics³.

Choice D reason: This is the correct order, as starting high dose antibiotics, obtaining serial blood cultures, and putting the child on high flow oxygen are the appropriate interventions for infective endocarditis. Antibiotics are the main treatment to eradicate the infection and prevent complications. Serial blood cultures are done to monitor the response to antibiotics and identify the causative organism. High flow oxygen is given to improve the oxygen delivery and tissue perfusion¹².

Choice A reason: Giving the toddler planned, frequent, and nutritious snacks is a good way to meet her nutritional needs and respect her natural appetite. Toddlers have small stomachs and high energy levels, so they may not eat much at one sitting. They may also be easily distracted or bored by sitting at the table for too long. Snacks can provide additional calories and nutrients that they may miss at mealtimes. However, the snacks should be healthy, such as fruits, vegetables, cheese, yogurt, or whole-grain crackers. They should also be offered at regular times, not on demand, and not too close to mealtimes.

Choice B reason: Explaining to the toddler in a firm manner what is expected of her is not a helpful or realistic strategy to improve her eating habits. Toddlers are naturally curious and independent, and they may not understand or follow the rules that adults set for them. They may also resist or rebel against pressure or coercion to eat. Instead of lecturing or scolding the toddler, the parents should model good eating behaviors, praise her when she tries new foods, and avoid power struggles or arguments over food.

Choice C reason: Avoiding snacks so the toddler is hungry at mealtimes is not a wise or healthy suggestion. This may backfire and cause the toddler to become more fussy, irritable, or tired. It may also lead to overeating, bingeing, or unhealthy food choices later on. Hunger is not the only factor that influences a toddler's appetite. Other factors include mood, activity level, environment, and preferences. The parents should not use hunger as a tool to manipulate the toddler's eating, but rather respect her hunger and fullness cues.

Choice D reason: Offering rewards for eating at mealtimes is not a beneficial or sustainable method to encourage the toddler to eat. Rewards may be material, such as toys or stickers, or edible, such as sweets or desserts. Rewards may work temporarily, but they may also have negative consequences. They may undermine the toddler's intrinsic motivation to eat, or make her associate eating with external rewards rather than internal satisfaction. They may also create an imbalance in the value of different foods, or make the toddler feel guilty or deprived. The parents should not bribe or bargain with the toddler to eat, but rather make eating a pleasant and enjoyable experience.