A nurse is assisting in the care of a 6-year-old client who has nephrotic syndrome. Which of the following adverse effects of corticosteroids should the nurse recognize as having the potential to impact the child's psychosocial development? (Select All that Apply.)

A. Aspirin. Aspirin should never be given to a child with chickenpox due to the risk of Reye's syndrome, a rare but serious condition that can cause liver and brain damage when aspirin is used during viral infections.

B. Corticosteroid cream. While corticosteroids reduce inflammation, they are not recommended for chickenpox because they can suppress the immune response and potentially worsen the infection.

C. Oral antihistamine. Antihistamines such as diphenhydramine help relieve severe itching, which is a common symptom of chickenpox. Reducing itchiness can also help prevent scratching that may lead to skin infections and scarring.

D. Oral antibiotics. Chickenpox is caused by the varicella-zoster virus, so antibiotics are not needed unless a secondary bacterial infection (such as impetigo) develops from scratching the lesions.

A. The child's parents express concerns about seizure management during sleep, and the neurologist works to adjust the child's medication to decrease the incidence of nighttime seizures. This is an example of collaborative goal setting because the healthcare team listens to parental concerns and works together to modify treatment to improve the child’s seizure management. The neurologist, parents, and possibly the pediatrician are involved in decision-making, ensuring a team-based approach to care.

B. The child remains seizure-free after six months of taking a lower dosage of medication after a dose change by the provider. This is not collaborative goal setting because it describes an outcome rather than a team-based decision-making process. The provider adjusted the medication, but there is no mention of discussion or input from multiple members of the healthcare team or the child and parents.

C. The child expresses a desire to participate in a team sport at school, and the team determines which sports are safe and any necessary safety precautions with the child and parents. This is collaborative goal setting because it involves the child, parents, and healthcare team working together to find safe and appropriate activities. The discussion ensures that the child’s personal goals are supported while prioritizing their safety.

D. The nurse checks the child at each visit for mental health concerns and relays their assessment findings to the parents, child life specialist, and pediatrician. This is an example of collaborative care because the nurse shares important assessment findings with the interdisciplinary team. By involving the pediatrician and child life specialist, the team can address the child’s mental health in addition to their physical condition.

E. The child's parents receive suggestions about complementary therapies from a family member and begin using them for their own child. This is not an example of collaborative goal setting because the healthcare team was not involved in the decision-making process. Effective collaboration requires input from qualified professionals, ensuring that treatments are safe and evidence-based.