A nurse is caring for a pediatric patient with congestive heart failure (CHF). What major goal should the nurse include in the care of this patient?

The correct answer is choice A. Takes a bubble bath every day.

Choice A rationale:

Bubble baths can cause urinary tract infections (UTIs) in children. The soap and bubbles can irritate the child’s privates, leading to discomfort and potentially contributing to the development of a UTI. It’s particularly true for young girls, as exposure to soap and bubbles can hurt their privates, leaving them itchy and uncomfortable. While not the most common cause, bubble baths have been associated with UTIs due to the irritation they can cause.

Choice B rationale:

While handwashing is crucial for preventing the spread of germs, there is less direct evidence linking the lack of handwashing after toileting to UTIs. However, good hygiene practices, including handwashing, are generally recommended to reduce the risk of infections.

Choice C rationale:

Carbonated beverages have been associated with bladder irritation and UTIs in some cases. They can cause problems for individuals with interstitial cystitis, bladder stones, and UTIs due to the carbonic acid they contain. However, the link between carbonated beverages and UTIs is not as direct as that of bubble baths.

Choice D rationale:

Wiping the perineal area from front to back after toileting is actually a recommended practice to prevent UTIs. It helps to prevent bacteria from the stool from contaminating the urethra and bladder, which can lead to an infection. Therefore, this choice is unlikely to be related to the client’s UTI.

In conclusion, the most likely data related to the client’s urinary tract infection is the daily bubble baths, as they can directly irritate the urinary tract and create conditions conducive to a UTI.

Choice A rationale:

Avoid setting limits or establishing disciplinary guidelines is not appropriate. Children with cognitive impairment require structure and consistent boundaries to ensure their safety and development.

Choice B rationale:

Encouraging the child to socialize with same-aged children is important for their social and emotional development. Interaction with peers fosters communication skills and helps them integrate into society.

Choice C rationale:

Avoid discussing sexuality until the child is an adult may lead to misinformation and confusion. Addressing sexuality in an age-appropriate manner is vital to help the child develop a healthy understanding of their body and relationships.

Choice D rationale:

Encouraging delaying the child's entry into educational programs hinders their cognitive and intellectual growth. Early intervention and tailored educational programs are crucial for children with cognitive impairment to reach their full potential.