A nurse is caring for a preschooler who has epiglottitis from a streptococcal infection. Which of the following actions should the nurse take?

A. Maintain night splints to the affected joint: Night splints help maintain joint position and function during sleep, preventing contractures and deformities. This is a common intervention in managing juvenile rheumatoid arthritis to ensure proper joint alignment and minimize pain and stiffness.

B. Encourage the child to take daytime naps: Daytime naps can lead to prolonged periods of immobility, which may increase stiffness and pain in joints. Maintaining regular activity and exercise is usually recommended to preserve joint function.

C. Administer opioids on a schedule: Opioids are not typically first-line treatment for juvenile rheumatoid arthritis due to potential side effects and risk of dependence. Nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs) are more commonly used.

D. Apply cool compresses for 20 min every hour: Cool compresses may provide temporary relief for acute joint pain but are not recommended on a regular schedule due to risk of skin damage and reduced joint flexibility. Heat application is more commonly used for chronic pain relief in arthritis.

A. Avoid a diet consisting of primarily milk. Milk, especially cow’s milk, is low in iron and can inhibit iron absorption. Excessive milk consumption can also lead to iron deficiency anemia by displacing iron-rich foods from the diet and potentially causing gastrointestinal bleeding in infants. Limiting milk intake and ensuring a balanced diet can help prevent iron deficiency.

B. Include whole grains and legumes in the diet. Whole grains and legumes are good sources of nonheme iron, which is beneficial for preventing iron deficiency anemia. While this is a good dietary recommendation, infants might not consume enough of these foods to meet their iron needs without additional sources or supplements.

C. Administer fat-soluble vitamins daily. Rationale: Fat-soluble vitamins (A, D, E, K) are not directly related to preventing iron deficiency anemia. They are important for other aspects of health, but they do not address iron intake or absorption.

D. Limit intake of high-protein foods. Rationale: High-protein foods like meat are often rich in heme iron, which is easily absorbed and important for preventing anaemia. Limiting these foods would not be beneficial and might even contribute to anemia.