A newborn with a repaired gastroschisis is transferred to the pediatric unit after several days in the pediatric intensive care unit. The infant is receiving parenteral nutrition and continuous enteral feedings. To maintain normal growth and development of the infant, which action should the nurse include in plan of care?

When advising a new mother in caring for a child with croup, the symptom that should be a priority concern to the telephone triage nurse is B.

Explanation:

A. A fever of 101.0°F (38.3°C) is a common symptom in many childhood illnesses, including croup, but it is not the primary concern when difficulty swallowing secretions is present.

B Difficulty swallowing secretions.

Croup is characterized by a barking cough and may also be associated with stridor (noisy breathing), hoarseness, and difficulty swallowing secretions. While all the symptoms mentioned can be concerning, difficulty swallowing secretions is a priority concern because it can potentially lead to respiratory distress if not managed appropriately. Thick secretions can cause airway obstruction, and prompt assessment and intervention are needed to ensure the child's airway remains clear and that the child is able to breathe effectively.

C. A barking cough, worse at night, is a classic symptom of croup and should be addressed, but difficulty swallowing secretions can have a more direct impact on the child's airway.

D. Crying often when nursing may be related to the discomfort caused by croup, but it is not as immediately concerning as difficulty swallowing secretions.

While the barking cough, hoarseness, and other croup symptoms should also be addressed, the priority is ensuring that the child is able to manage secretions effectively without respiratory distress. The telephone triage nurse should provide guidance to the mother on how to help the child manage these secretions and when to seek medical attention if the situation worsens.

The intervention the nurse should implement when the child screams and tries to hide behind the parent, dropping a stuffed toy during the collection of the medical history is B.

A. Ignoring the child's behavior and directing questions only to the parent may further distress the child and make them more anxious. It's important to acknowledge the child's feelings and create a supportive environment.

B. Include the child's toy in the collection of information.

Children can become anxious or fearful in healthcare settings, and using strategies to make them feel more comfortable and involved can help build trust. By including the child's toy in the collection of information, the nurse can create a more relaxed and child-friendly atmosphere. This can help the child feel less threatened and more willing to participate in the history-taking process.

C. Documenting interactions between the parent and the child is important for the medical record, but it doesn't address the child's current distress.

D. Obtaining essential information as quickly as possible, without considering the child's comfort and engagement, may not yield the best history and could potentially create resistance and fear in the child.

Therefore, including the child's toy in the process, making the interaction child-friendly, and acknowledging the child's comfort are essential to improve the experience and gather necessary information in a more relaxed atmosphere.