A nurse is caring for a client who has borderline personality disorder (BPD). As part of the client's plan of care, the nurse reviews the day's schedule with the client each morning. As the nurse begins to review the schedule with the client, the client says, "Why don't you shut up already? I can read it myself, you know!" Which of the following responses should the nurse give the client?

A. Provide a small electronic toy.

Providing a small electronic toy can engage the infant's senses and promote cognitive development. Interactive toys can stimulate the infant's curiosity, encourage exploration, and provide sensory stimulation, which are important aspects of infant development. However, the selection of toys should consider safety and age appropriateness, ensuring they do not pose a choking hazard or contain small parts that the infant could ingest.

B. Change the infant's diaper as soon as soiling occurs.

Changing the infant's diaper promptly when soiling occurs is essential for maintaining hygiene and preventing skin irritation or infection. However, while diaper changes are necessary for the infant's comfort and well-being, they primarily address basic needs rather than directly promoting growth and development related to the hip dysplasia.

C. Allow the infant to stand in the crib.

Allowing the infant to stand in the crib may not be suitable, especially if the infant is in a cast for developmental dysplasia of the hip (DDH). The cast is typically intended to maintain the hip joint in a specific position to promote proper alignment and development. Allowing the infant to stand in the crib could compromise the effectiveness of the treatment and potentially exacerbate the hip dysplasia. Therefore, this option is not appropriate.

D. Tie colorful latex balloons to the side of the crib.

Tying colorful latex balloons to the side of the crib is not recommended due to safety concerns. Latex balloons pose a choking hazard if they deflate or rupture, and the infant could accidentally ingest the latex material, leading to airway obstruction or other complications. Safety is paramount in infant care, and any potential hazards should be avoided.

A. Before auscultating the chest and abdomen: Examining the tympanic membrane before auscultating the chest and abdomen is not ideal. It's important to follow a systematic approach in physical examination, typically starting with less invasive assessments before progressing to more invasive or uncomfortable ones. Therefore, examining the tympanic membrane before auscultating the chest and abdomen may disrupt this systematic approach.

B. Before examining the head and neck: Similarly, examining the tympanic membrane before examining the head and neck is not appropriate. The head and neck examination typically includes less invasive assessments such as observing the child's appearance, palpating the fontanelles, and inspecting the scalp, face, and neck. The tympanic membrane examination, which involves using an otoscope, is more invasive and should be performed later in the examination.

C. At the end: This is the correct choice. Examining the tympanic membrane at the end of the physical examination allows the nurse to establish rapport with the child and gain their cooperation before performing a potentially uncomfortable or intrusive examination of the ears. Starting with less invasive and more familiar assessments, such as observing the child's general appearance and behavior, auscultating the chest and abdomen, and examining the head and neck, can help build trust and reduce anxiety before proceeding to more specific assessments, such as otoscopy.

D. At the beginning: Examining the tympanic membrane at the beginning of the physical examination may cause the child distress and anxiety, potentially making the rest of the examination more challenging. It's preferable to perform less invasive assessments first to help the child become more comfortable and cooperative before proceeding to more invasive examinations like otoscopy. Therefore, examining the tympanic membrane at the beginning is not recommended.