A nurse is caring for a 3-year-old toddler who was newly admitted with pertussis in stage 2 (the paroxysmal stage) of the illness. Which of the following interventions should the nurse perform first?

A. Toddlers with bleeding disorders should only receive one vaccine at a time due to the risk of bleeding at injection site: While spacing vaccines is not necessary solely for bleeding risk, precautions such as using smaller needles, applying firm pressure after injection, and choosing appropriate injection sites are recommended. Receiving multiple vaccines is generally safe.

B. Toddlers with von Willebrand disease should only receive vaccines available as nasal sprays to avoid bleeding from intramuscular injections: Nasal vaccines are limited in availability and type. Intramuscular vaccines can still be safely administered with proper technique and post-injection pressure, making this recommendation unnecessary and restrictive.

C. Toddlers with bleeding disorders are encouraged to stay up-to-date on vaccinations. The benefit of vaccinations outweighs the risk of bleeding: Maintaining the routine vaccination schedule protects children with bleeding disorders from serious infections. With proper precautions, the risk of bleeding at injection sites is minimal and manageable.

D. Toddlers with bleeding disorders should not receive any vaccinations, because the risk of bleeding outweighs the benefit of the vaccinations: Avoiding vaccines exposes the child to preventable infectious diseases. Careful technique and monitoring allow safe vaccination without withholding protection.

A. "You should allow your child to play any sport they want to play.": Allowing unrestricted participation in all sports ignores the increased bleeding risk associated with hemophilia. High-impact or contact sports could result in serious injury or joint bleeding. Safety precautions and age-appropriate activity selection are necessary.

B. "You should allow your child to participate in age-appropriate activities, such as riding a bike using proper protective gear.": Children with hemophilia benefit from physical activity to maintain muscle strength, joint mobility, and overall health. Encouraging safe, age-appropriate activities with protective equipment balances activity participation with minimal bleeding risk.

C. "You should not allow your child to ride a bike or go skateboarding with their classmates.": Overly restrictive guidance can limit the child’s development, socialization, and confidence. With proper supervision, protective equipment, and selection of low-risk activities, many activities can be safely performed. Total restriction is unnecessary.

D. "You should not allow your child to play any sport due to the risk of injury.": Complete avoidance of sports can lead to decreased muscle strength, reduced joint function, and psychosocial consequences such as isolation or low self-esteem. Education should focus on safe participation rather than forbidding all activity.