A nurse is caring for a child who has influenza. The nurse should identify which of the following statements by the parent indicates the child has an increased risk for Reye syndrome.

Choice A reason: This choice is correct because examining the child's tympanic membrane at the end of the physical examination is the best strategy to avoid upsetting or frightening the child. The tympanic membrane is the thin membrane that separates the outer ear from the middle ear, and it can be examined by using an otoscope, which is a device that has a light and a magnifying lens. Examining the tympanic membrane may be uncomfortable or painful for the child, especially if they have an ear infection or inflammation. Therefore, performing this procedure at the end of the examination can help to minimize the child's distress and resistance.

Choice B reason: This choice is incorrect because examining the child's tympanic membrane before auscultating the chest and abdomen is not a good strategy to avoid upsetting or frightening the child. Auscultating the chest and abdomen is a procedure that involves listening to the sounds of the heart, lungs, and bowel by using a stethoscope, which is a device that has a chest piece and earpieces. Auscultating the chest and abdomen may be soothing or relaxing for the child, as it does not cause any discomfort or pain. Therefore, performing this procedure before examining the tympanic membrane can help to calm and distract the child.

Choice C reason: This choice is incorrect because examining the child's tympanic membrane at the beginning of the physical examination is not a good strategy to avoid upsetting or frightening the child. Examining the tympanic membrane at the beginning of the examination may cause anxiety or fear in the child, which can affect their cooperation and trust for the rest of the examination. Therefore, performing this procedure at the beginning of the examination can increase the child's distress and resistance.

Choice D reason: This choice is incorrect because examining the child's tympanic membrane before examining the
head and neck is not a good strategy to avoid upsetting or frightening the child. Examining the head and neck is a procedure that involves inspecting and palpating the scalp, hair, face, eyes, ears, nose, mouth, throat, lymph nodes, and thyroid gland. Examining the head and neck may be easy or pleasant for the child, as it does not cause any discomfort or pain. Therefore, performing this procedure before examining the tympanic membrane can help to establish rapport and confidence with the child.

Choice A: Toys that can't be dry cleaned or washed do not need to be thrown out, as they can be treated by sealing them in plastic bags for two weeks or placing them in a freezer for two days. This will kill any lice or nits that may have been transferred from the child's head.

Choice B: Nits will not always be present, as they can be removed by using a fine-toothed comb or applying products that loosen their attachment to the hair shafts. Nits are the eggs of lice that are glued to the hair near the scalp. Nits can hatch into nymphs within seven to ten days and mature into adult lice within another seven to ten days.

Choice C: All recently used clothing, bedding, and towels must be washed in hot water, as this will kill any lice or nits that may have been transferred from the child's head. Hot water means at least 54°C/130°F for at least ten minutes. The items should also be dried in high heat for at least twenty minutes.

Choice D: Treating all the family members is not necessary, as only those who have evidence of lice or nits should be treated with medicated shampoos or lotions that kill lice and prevent re-infestation. Treating all the family members may cause unnecessary exposure to chemicals or resistance to treatment.