A nurse is assisting with the care of a client.

Exhibits

Complete the following sentence by using the list of options. After notifying the provider, the nurse should

and then

A.Securing the tubing to the child's abdomen helps prevent accidental dislodgement or pulling of the gastrostomy tube. This can be done using appropriate securing devices, such as adhesive dressings or commercially available tube holders, as recommended by the healthcare provider.

B.Taping the tube to the child's cheek is not a recommended practice. It can cause skin irritation, discomfort, or even accidental removal of the tube. Proper securing of the tube to the abdomen using appropriate devices is the preferred method to prevent dislodgement.

C.Some gastrostomy tubes require an extension set for feeding, especially low-profile devices (e.g., button-type gastrostomy tubes). This extension makes it easier to administer feeds or medications and can be removed afterward. However, this is not typically part of routine site care.

D.Applying lubricant to the site is not necessary or recommended. The gastrostomy tube should be kept clean and dry. If any secretions or debris are present, they should be gently cleaned with mild soap and water, followed by thorough rinsing and drying.

The correct answer is choiceB. Fever.

Choice A rationale:

Peeling of the hands and feet is not a typical manifestation of pertussis.This symptom is more commonly associated with conditions like Kawasaki disease.

Choice B rationale:

Fever is a common symptom in the early stages of pertussis, along with a mild cough and runny nose.

Choice C rationale:

A beefy, red tongue is not associated with pertussis.This symptom is more characteristic of scarlet fever.

Choice D rationale:

Facial erythema is not a typical symptom of pertussis.Pertussis primarily affects the respiratory system, causing severe coughing fits.