A nurse is caring for a group of clients.
Which of the following findings should the nurse report to the provider?

Choice A rationale

While it’s important for a child to have adequate sleep, waiting until the child indicates that they are tired before putting them to bed may not be the best approach. Children often do not recognize their own signs of fatigue and may become overtired, which can actually make it more difficult for them to fall asleep and stay asleep.

Choice B rationale

Allowing a child to watch an animated movie before bedtime may seem like a harmless routine, but it can actually interfere with their sleep. The light from the screen can suppress the production of melatonin, the hormone that regulates sleep, and the content of the movie can be stimulating rather than relaxing.

Choice C rationale

Waking your child up during a night terror can be beneficial. Night terrors occur during the deepest stages of sleep and can be frightening for both the child and the parents. By gently waking your child before the usual time of a night terror, you can interrupt the sleep cycle and potentially prevent the night terror from occurring.

Choice D rationale

While it may be tempting to allow your child to sleep in your bed, especially if they are experiencing night terrors, this is not typically recommended. Co-sleeping can create a dependency and make it more difficult for the child to learn to self-soothe and fall asleep independently.

The correct answer is choiced. Encourage the adolescent to perform incentive spirometry to maintain lung capacity.

Choice A rationale: Avoiding influenza and pneumococcal vaccines for 24 months is not recommended. Vaccinations are crucial for preventing respiratory infections, which can be particularly dangerous for individuals with muscular dystrophy due to their compromised respiratory function.

Choice B rationale: Initiating a referral for chest physiotherapy every 4 hours is excessive and impractical. While chest physiotherapy can be beneficial, it is typically recommended at a frequency that is manageable and tailored to the individual’s needs.

Choice C rationale: Recommending the adolescent use a wheelchair to prevent stress on the lower extremities is not ideal. Encouraging mobility and physical activity as tolerated is important to maintain muscle strength and function for as long as possible.

Choice D rationale: Encouraging the adolescent to perform incentive spirometry to maintain lung capacity is appropriate. Incentive spirometry helps improve lung function and prevent respiratory complications, which are common in individuals with muscular dystrophy.