A mother brings her preteen daughter to the clinic for her first female examination. During the health assessment, the nurse should implement which technique to determine if the client has reached the age of menarche?

Choice A reason: Careful bathing and handling that avoids abdominal manipulation is the best intervention that the nurse can implement during the preoperative period. This is because Wilms' tumor is a rare kidney cancer that mainly affects children and can rupture or spread if touched or pressed. The nurse should avoid any unnecessary pressure on the abdomen and use gentle movements when bathing and handling the infant.

Choice B reason: Administering pain medication based on the FACES pain scale is not the best intervention that the nurse can implement during the preoperative period. This is because the FACES pain scale is a tool that helps children aged 3 and older to communicate their pain level by pointing to a face that matches their pain. However, the infant in this scenario is too young to use this scale and may not be able to express their pain verbally. The nurse should use other methods to assess the infant's pain, such as observing their behavior, vital signs and facial expressions.

Choice C reason: Including the prone position in the every 2 hour turning schedule is not the best intervention that the nurse can implement during the preoperative period. This is because the prone position, which is lying on the stomach, can increase the risk of rupture or spread of the tumor. The nurse should avoid placing the infant in this position and instead use other positions that are comfortable and safe for the infant.

Choice D reason: Giving antiemetic medications to prevent nausea and vomiting is not the best intervention that the nurse can implement during the preoperative period. This is because antiemetic medications are drugs that prevent or treat nausea and vomiting caused by chemotherapy, radiation therapy or surgery. However, the infant in this scenario has not yet undergone any of these treatments and may not have any symptoms of nausea and vomiting. The nurse should only give antiemetic medications if the infant shows signs of nausea and vomiting or if prescribed by the doctor.

Choice A reason: Instilling benzocaine otic drops regularly is not a recommended practice for preventing or treating otitis media. Benzocaine is a topical anesthetic that can temporarily relieve ear pain, but it does not address the underlying cause of the infection. Moreover, benzocaine can cause allergic reactions, skin irritation, or methemoglobinemia, a condition that reduces the oxygen-carrying capacity of the blood. The nurse should instruct the caregiver to avoid using benzocaine otic drops unless prescribed by a health care provider.

Choice B reason: Avoiding any smoking inside the house is a good practice for preventing otitis media. Smoking can irritate the respiratory tract and impair the function of the cilia, the hair-like structures that help clear mucus and bacteria from the middle ear. Smoking can also increase the risk of respiratory infections, allergies, and asthma, which are associated with otitis media. The nurse should praise the caregiver for avoiding smoking and encourage them to maintain a smoke-free environment for the infant.

Choice C reason: Giving the infant the full course of antibiotics is a necessary practice for treating otitis media. Antibiotics can help eliminate the bacteria that cause the infection and reduce the inflammation and pain in the middle ear. However, antibiotics should be used only when prescribed by a health care provider, and the caregiver should follow the instructions carefully. The nurse should remind the caregiver to give the infant the exact dose of antibiotics at the right time and for the entire duration of the treatment, even if the symptoms improve.

Choice D reason: Scheduling a visit for pneumococcal vaccine is a preventive measure for otitis media. Pneumococcal vaccine can protect the infant from the most common strains of Streptococcus pneumoniae, a bacterium that causes otitis media and other serious infections. The vaccine is recommended for all children under 2 years of age, and it is given in four doses at 2, 4, 6, and 12 to 15 months of age. The nurse should verify the infant's immunization status and advise the caregiver to follow the recommended schedule for the pneumococcal vaccine.