A nurse is assisting in the care of a client who has a long-term suprapubic catheter in place and is eager to learn how to care for the catheter. The nurse recognizes that a child in which of the following psychosocial developmental stages may be ready for this education?

A. "Lack of supervision is a big risk factor for burns in children." This is correct. Young children are naturally curious and have limited awareness of danger, making them more prone to thermal injuries. Inadequate supervision increases the risk of burns from hot liquids, open flames, electrical sources, and heated objects.

B. "Microwaved food should sit for 30 seconds before giving to the child." While allowing food to cool is helpful, 30 seconds may not be enough time to reduce the risk of burns. Additionally, caregivers should stir microwaved food thoroughly to distribute heat evenly and test the temperature before feeding the child.

C. "Young children should be kept indoors at all times to prevent sunburns." This is unrealistic and unnecessary. Instead, caregivers should use protective measures such as sunscreen, hats, protective clothing, and shade to prevent sunburn while allowing outdoor activities.

D. "The water heater should be set at 130 degrees Fahrenheit or less." This is incorrect. The recommended maximum water heater temperature is 120°F (49°C) to prevent scald burns. Water at 130°F can cause serious burns within seconds, making it too high for safety.

Down Syndrome

• Prenatal diagnosis common
• Intellectual disability (mild to moderate)
• Joint laxity (hypotonia, loose joints)
• Gastrointestinal issues (GERD, duodenal atresia, feeding difficulties)
• Cardiac defects (AVSD, VSD, ASD)

Fragile X Syndrome

• Intellectual disability (most common inherited cause)
• Increased likelihood of seizures
• Joint laxity (connective tissue abnormalities)

Autism Spectrum Disorder (ASD)

• Intellectual disability (varies, not always present)
• Increased likelihood of seizures

Rationale:

Prenatal diagnosis common: Down syndrome is often diagnosed prenatally via noninvasive prenatal testing (NIPT), chorionic villus sampling (CVS), or amniocentesis. Fragile X and ASD do not have standard prenatal screening tests. Fragile X is typically diagnosed after developmental delays emerge, and ASD is diagnosed based on behavioral assessments.

Intellectual disability: Most individuals with Down syndrome experience mild to moderate intellectual disability. Fragile X is the most common inherited cause of intellectual disability, especially in males. While ASD does not always involve intellectual disability, some individuals with severe ASD may have cognitive impairments.

Increased likelihood of seizures: While seizures can occur, they are not a hallmark of Down syndrome. Individuals with Fragile X have a higher risk of epilepsy, particularly in childhood. ASD is associated with higher seizure rates, especially in those with intellectual disability.

Joint laxity (loose joints, hypermobility): Hypotonia (low muscle tone) and joint laxity are common in Down syndrome, affecting movement and motor skills. Fragile X also causes connective tissue abnormalities, leading to joint hypermobility. ASD does not typically cause joint laxity.

Gastrointestinal issues: Individuals with Down syndrome often have GERD, feeding difficulties, and congenital GI anomalies like duodenal atresia and Hirschsprung disease. While some individuals with Fragile X Syndrome & Autism Spectrum Disorder may have GI issues, they are not primary features.

Cardiac defects: Congenital heart defects (e.g., atrioventricular septal defect, ASD, VSD) are very common in Down syndrome. Fragile X Syndrome & Autism Spectrum Disorder do not have a strong association with congenital heart disease.