A nurse is caring for a 5-year-old child who has nephrotic syndrome who weighs 12 kg (26.5 lb) and is postoperative following open-heart surgery. Which of the following findings suggests that the management has been effective?

A. "You should use a mild detergent for your child's laundry.": Correct. Using a mild detergent helps to minimize irritation and sensitivity, especially for children with skin conditions like eczema, which may benefit from pimecrolimus cream.
B. "You can apply gloves to your child's hands.": Correct. Applying gloves can prevent scratching and further irritation to the skin, especially if the child has lesions or eczema on their hands.
C. "You should cut and file your child's fingernails frequently.": Correct. Keeping the child's fingernails short and filed can prevent accidental scratching and trauma to the skin, reducing the risk of exacerbating skin lesions.
D. "You should apply emollients to your child's skin after bathing.": Correct. Emollients help to moisturize the skin and prevent dryness, which can be beneficial for children with skin conditions like eczema. Applying emollients after bathing helps to lock in moisture.
E. "You should apply a thick layer of pimecrolimus cream to your child's lesions.": Incorrect. Pimecrolimus cream should be applied in a thin layer to the affected skin areas, as directed by the healthcare provider. Using a thick layer may not improve efficacy and could increase the risk of side effects.
F. "Your child's condition is contagious when lesions are present.": Correct. It's important for the guardian to understand that certain skin conditions, such as eczema, may not be contagious themselves but can become infected if lesions are present and scratched, leading to bacterial or viral infections.
G. "Your child will experience occasional flare-ups of this condition.": Correct. Skin conditions like eczema often have a chronic and relapsing course, with periods of exacerbation (flare-ups) and remission. Providing this information helps the guardian understand the chronic nature of the condition and the need for ongoing management and monitoring.

A. Consult the Child Life Specialist to speak with the sibling. Child Life Specialists are trained to help children and their families cope with illness, hospitalization, and the end-of-life process. This is an appropriate and supportive action.

B. Discourage the sibling from talking about their feelings with the child. Discouraging the sibling from expressing their feelings can be harmful and inhibit healthy emotional processing. Open communication should be encouraged.

C. Limit the amount of time the sibling spends at the hospital. Limiting time at the hospital might make the sibling feel excluded or increase feelings of fear and anxiety. Involvement and presence can be beneficial for coping.

D. Have the sibling leave the room during the child's care. Excluding the sibling during care can increase feelings of anxiety and helplessness. Involvement in appropriate aspects of care can be helpful for the sibling's coping process.