A home health nurse is providing care to a child who has cerebral palsy and notes that the child's parent seems withdrawn. The nurse asks the parent how they are doing, and the parent begins crying and states that taking care of their child is “so hard sometimes" and they are not sure how much more stress they can take. Which of the following statements made by the nurse's the most appropriate response?

A. Warm the medication container for 10 seconds in a microwave oven prior to instillation. Using a microwave to warm ear drops is unsafe, as it can cause uneven heating and potentially burn the delicate ear structures. Instead, the medication should be warmed by holding the container in the hands for a few minutes.

B. Apply clean gloves and clean the outer ear prior to instilling drops. Wearing gloves prevents contamination, and cleaning the outer ear removes purulent drainage, ensuring the medication reaches the ear canal properly. This is an essential step in infection control and medication effectiveness.

C. Firmly push a cotton ball into the ear canal after instilling drops. Inserting a cotton ball too firmly can trap moisture and bacteria, potentially worsening the infection. If needed, a loosely placed cotton ball may be used, but it should not be forced into the canal.

D. Pull the child's ear auricle upward and outward just before instilling drops. This technique is used for adults and children over 3 years old. In a 2-year-old, the correct method is to pull the auricle downward and back to straighten the ear canal for proper medication administration.

A. Suppression of pro-inflammatory cytokines. Psoriasis is driven by an increase, not suppression, of pro-inflammatory cytokines like TNF-α, IL-17, and IL-23. These cytokines trigger excessive skin cell proliferation and inflammation.

B. Increased production of sebum. Sebum production is linked to conditions like seborrheic dermatitis and acne, not psoriasis. Psoriasis is an autoimmune disorder rather than a condition caused by oil overproduction.

C. Overactivation of T-cells. Psoriasis is an immune-mediated disorder where overactive T-cells attack healthy skin cells, leading to increased inflammation and rapid skin cell turnover. This results in the formation of thick, scaly plaques seen in psoriasis.

D. Decreased number of Langerhans cells in the dermis. Langerhans cells are antigen-presenting cells involved in immune defense. While they may play a role in immune regulation, psoriasis is primarily caused by T-cell hyperactivity rather than a reduction in Langerhans cells.