A nurse is caring for a client during an initial prenatal visit.
The client's last menstrual period was 18 weeks ago. Which of the following actions should the nurse plan to take? (Select All that Apply.)

Choice A rationale

Restraining a child with autism can exacerbate distress and lead to further agitation due to sensory overload and a feeling of loss of control. Physical restraint can activate the sympathetic nervous system, increasing heart rate and cortisol levels, which can traumatize the child and hinder therapeutic rapport, contravening principles of trauma-informed care.

Choice B rationale

Hand flapping and rocking are common self-stimulatory behaviors, or "stimming," in children with autism, serving to regulate sensory input and manage anxiety. Allowing these behaviors in a low-stimulus environment supports emotional regulation by reducing external stressors and promoting a sense of security, which is crucial for individuals with sensory processing differences.

Choice C rationale

Immediately redirecting or attempting to stop self-stimulatory behaviors can be counterproductive for a child with autism. These behaviors often serve a vital self-regulatory function; interrupting them without providing an alternative coping mechanism can increase anxiety, frustration, and escalate behavioral challenges, disrupting their internal equilibrium.

Choice D rationale

Engaging in verbal interaction to distract a child with autism during self-soothing can disrupt their regulatory process. Children with ASD often have difficulties with social communication and may find unexpected verbal input overwhelming, potentially increasing sensory overload and agitation, rather than providing effective distraction or comfort.

Choice A rationale

Legg-Calvé-Perthes disease involves avascular necrosis of the femoral head, requiring strict adherence to prescribed treatment, such as bracing or limited weight-bearing, to promote revascularization and prevent femoral head deformity. Non-compliance significantly increases the risk of long-term osteoarthritis and functional limitations.

Choice B rationale

Legg-Calvé-Perthes disease is not a terminal illness. While it can lead to chronic hip problems if not properly managed, it is a self-limiting condition where the bone eventually regenerates, albeit sometimes with residual deformity.

Choice C rationale

While pain management may be necessary, antibiotics are not a primary treatment for Legg-Calvé-Perthes disease as it is an aseptic necrosis, not an infection. The focus is on preserving the femoral head and restoring its blood supply.

Choice D rationale

Rehabilitation to regain mobility might be part of the long-term management after the acute phase or surgery, but the initial and key focus is on preventing further damage to the femoral head and ensuring proper healing, which often involves activity restriction.