A nurse is assisting with preparing a toddler for an intravenous procedure.
Which of the following actions should the nurse take? (Select all that apply)

Choice A rationale

While assistance may be needed to comfort the toddler during the procedure, holding the toddler in a prone position is not the recommended position for a lumbar puncture.

Choice B rationale

Placing the toddler in a side-lying, knee-chest position is the correct position for a lumbar puncture. This position helps to open up the spaces between the vertebrae, making it easier to access the spinal canal.

Choice C rationale

Restraining the toddler for 1 hour after the procedure is not necessary and could cause distress to the toddler.

Choice D rationale

While swaddling the toddler in a warm blanket may provide comfort, it is not a necessary step in the administration of a lumbar puncture.

Choice A rationale

The FACES scale is a valid tool for assessing pain in children aged 3 years and older. It uses a series of faces to help the child express their level of pain.

Choice B rationale

The Visual Analog Scale is typically used for adults and older children who can understand the concept of ranking their pain on a scale from 0 to 10. It may not be suitable for a 3-year-old child.

Choice C rationale

A color tool may not be effective for a 3-year-old child as they may not yet fully understand the concept of associating colors with different levels of pain.

Choice D rationale

A numeric scale is typically used for adults and older children who can understand the concept of ranking their pain on a scale from 0 to 10. It may not be suitable for a 3-year-old child.