A nurse is assessing a school-age child who is receiving cefazolin. For which of the following adverse effects should the nurse monitor?

A. Rhinorrhea (runny nose) is a common symptom of respiratory syncytial virus (RSV) and may not require immediate reporting unless severe or accompanied by other concerning symptoms.
B. Pharyngitis (sore throat) is not typically considered a critical finding in RSV infection.
C. Coughing is a common symptom of RSV and is expected in infants with the infection. While coughing may require monitoring, it is not typically an immediate cause for concern unless severe.

D. Tachypnea (rapid breathing) is a concerning finding in infants with RSV infection, especially if it is severe or accompanied by signs of respiratory distress. Severe tachypnea may indicate worsening respiratory compromise and requires immediate attention and reporting to the healthcare provider for further evaluation and management.

Rationale:

A. While EMLA cream can provide local anesthesia, it takes time to take effect and might not be practical for immediate use before administering immunizations.

B. Providing a pacifier coated with an oral sucrose solution has been shown to reduce pain and stress during immunizations in infants, promoting atraumatic care.

C. Injecting immunizations into the deltoid muscle is a common practice, but it does not specifically address atraumatic care.

D. Using a smaller gauge needle (e.g., 22-25 gauge) is generally recommended for infants to minimize pain, but specifying a 20-gauge needle is not necessarily related to atraumatic care.