A child with spastic cerebral palsy is to receive botulin toxin.

The nurse prepares the child for administration of this drug by which route?

Choice A rationale

Astigmatism is an irregular curvature of the cornea or lens, which causes light rays to focus unevenly on the retina, resulting in distorted or blurred vision at any distance. The primary treatment for astigmatism is the use of corrective lenses, such as eyeglasses or contact lenses, not therapeutic eye patching.

Choice B rationale

Hyperopia, or farsightedness, occurs when the light focuses behind the retina because the eyeball is too short or the cornea is too flat, causing difficulty seeing objects up close. This condition is primarily managed by prescribing convex corrective lenses to help shift the focal point onto the retina.

Choice C rationale

Myopia, or nearsightedness, occurs when the light focuses in front of the retina because the eyeball is too long or the cornea is too steep, causing blurry distance vision. The standard treatment involves concave corrective lenses to diverge light rays and properly position the focal point on the retina.

Choice D rationale

Amblyopia, commonly called "lazy eye," is a reduction in visual acuity in one eye that results from the eye and brain not working well together, often caused by untreated strabismus or refractive errors. Patching the strong eye forces the brain to use the weaker, amblyopic eye, stimulating the development of the neural pathways necessary for clear vision.

Choice A rationale

The normal range for meconium passage is generally within the first 24 to 48 hours of life. A 16-hour-old newborn who has not yet passed any meconium is still within the expected time frame and is not an immediate cause for alarm, although documentation is important. However, the nurse should continue to monitor for bowel sounds and abdominal distention.

Choice B rationale

The normal blood glucose level for a newborn is typically 45 mg/dL or higher. A glucose level of 55 mg/dL for a 16-hour-old newborn is within the acceptable and safe range, indicating adequate metabolic function and requiring only routine monitoring rather than immediate reporting to the healthcare provider.

Choice C rationale

A respiratory rate of 70 breaths/minute in a 2-day-old newborn (48 hours old) is tachypnea, as the normal range is 30 to 60 breaths/minute. Persistent tachypnea beyond the immediate transitional period, especially when associated with an irregular pattern, is a sign of potential respiratory distress or other underlying pulmonary or cardiac pathology and must be reported immediately.

Choice D rationale

Excreting a milky discharge (sometimes called "witch's milk") from the nipples in both female and male newborns is a common and benign temporary condition caused by the withdrawal of maternal hormones (estrogen and prolactin) after birth. This is a normal, transient finding and does not require reporting to the healthcare provider.