A fourteen-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 a good choice. Delaying dental visits until the child's heart defect is fully repaired is not a recommended practice. Dental hygiene is important for preventing oral infections that can spread to the bloodstream and cause infective endocarditis. The child should have regular dental check-ups and cleanings, as well as good oral care at home.

Choice B reason: This is the correct choice. Administration of antibiotics one hour prior to all dental procedures is a critical teaching point to emphasize for parents of a child with a complex congenital heart defect. Dental procedures can cause bleeding and bacteria to enter the bloodstream, which can infect the damaged or abnormal heart valves and cause infective endocarditis. Antibiotics can prevent or reduce the risk of this complication by killing the bacteria before they reach the heart.

Choice C reason: This is not a good choice. Administration of daily prophylactic antibiotics is not a necessary or effective measure for preventing infective endocarditis in a child with a complex congenital heart defect. Daily antibiotics can cause side effects, such as allergic reactions, diarrhea, or yeast infections. They can also lead to antibiotic resistance, which can make the bacteria harder to treat if they do cause an infection.

Choice D reason: This is not a good choice. High dose IV antibiotics for 2-8 weeks is not a preventive strategy for infective endocarditis, but a treatment option for an established infection. IV antibiotics are given to eradicate the bacteria from the bloodstream and the heart valves and prevent further damage or complications. However, IV antibiotics are not always effective and may have serious s

Choice A reason: This statement is correct, as breastfeeding is the best source of nutrition and hydration for infants with diarrhea, as it provides antibodies, electrolytes, and fluids. The nurse should encourage the mother to continue breastfeeding per routine, or to offer expressed breast milk if the infant is too weak or fussy to nurse.

Choice B reason: This statement is incorrect, as Imodium is not recommended for infants with diarrhea, as it can cause serious side effects, such as ileus, toxic megacolon, or central nervous system depression. The nurse should advise the parents to avoid giving any anti-diarrheal medications to the infant, unless prescribed by the doctor.

Choice C reason: This statement is incorrect, as Kaopectate is not recommended for infants with diarrhea, as it contains bismuth subsalicylate, which can cause Reye syndrome, a rare but serious condition that affects the liver and brain. The nurse should advise the parents to avoid giving any anti-diarrheal medications to the infant, unless prescribed by the doctor.

Choice D reason: This statement is incorrect, as returning to daycare 24 hours after antibiotics have been started is not appropriate for infants with diarrhea secondary to rotavirus, as antibiotics are not effective against viral infections, and the infant may still be contagious and infect other children. The nurse should instruct the parents to keep the infant at home until the diarrhea has resolved, and to practice good hand hygiene and sanitation to prevent the spread of the infection.