A nurse in a provider's office is caring for an infant who has developmental dysplasia of the hip (DDH). The nurse should include which of the following instructions when teaching the parents about the Pavlik harness?

Choice A reason: Continuing to monitor the client is not the best action, as it does not address the low urine output of the child. The child has a urine output of 20 mL/hr, which is below the expected range of 30 to 40 mL/hr for a 3-year-old child. Low urine output can indicate dehydration, kidney injury, or urinary tract obstruction, which require prompt intervention.

Choice B reason: Performing a bladder scan at the bedside is not the most appropriate action, as it is not the first-line diagnostic tool for low urine output. A bladder scan is a noninvasive ultrasound device that measures the amount of urine in the bladder. It can help detect urinary retention, which is the inability to empty the bladder completely. However, urinary retention is unlikely in a 3-year-old child, and a bladder scan may not be accurate or reliable in children.

Choice C reason: Providing oral rehydration fluids is the best action, as it can help restore the fluid and electrolyte balance of the child. Oral rehydration fluids are solutions that contain water, sugar, and salt in specific proportions that match the body's needs. They can prevent or treat dehydration, which is a common cause of low urine output in children. The nurse should offer the child oral rehydration fluids every 15 to 20 minutes, and monitor the urine output, vital signs, and hydration status.

Choice D reason: Notifying the provider is not the first action, as it is not the most urgent or effective intervention for low urine output. The nurse should notify the provider after providing oral rehydration fluids and assessing the child's response. The nurse should also report any signs or symptoms of dehydration, such as dry mucous membranes, sunken eyes, poor skin turgor, or lethargy. The provider may order further tests or treatments, such as blood tests, urine tests, or intravenous fluids.

Choice A reason: Promising not to tell anyone about the abuse is not a helpful statement, as it implies that the abuse is a secret that should be hidden. This may make the child feel ashamed, guilty, or isolated. The nurse has a duty to report the abuse to the proper authorities and to protect the child from further harm.

Choice B reason: Blaming the family for the abuse is not a helpful statement, as it may cause the child to feel conflicted, angry, or fearful. The child may still love the family member who abused them, or may depend on them for their basic needs. The nurse should avoid making judgments or accusations, and instead focus on the child's feelings and safety.

Choice C reason: Reassuring the child that the abuse is not their fault is a helpful statement, as it may help the child cope with the trauma and reduce the feelings of self-blame, guilt, or shame. The nurse should validate the child's emotions and let them know that they are not responsible for the abuse or for stopping it.

Choice D reason: Suggesting to discuss the abuse with the family is not a helpful statement, as it may put the child in danger or cause them more distress. The child may not feel comfortable or safe to talk about the abuse with the family member who abused them, or with other family members who may not believe them or support them. The nurse should respect the child's privacy and boundaries, and only involve the family with the child's consent and under professional guidance.