A nurse is caring for a school-age child who has heart failure. Which of the following findings should the nurse expect? Select all that apply.

A. Respiratory rate 70/min: A respiratory rate of 70/min is high for an infant and may indicate ongoing respiratory distress or other issues. Normal respiratory rates for infants are generally 30-60 breaths per minute. This does not indicate improvement.

B. Capillary refill is greater than 3 seconds. Capillary refill time greater than 3 seconds indicates poor perfusion, which can be a sign of continued dehydration or shock. This does not indicate improvement.

C. Dry mucous membranes: Dry mucous membranes are a sign of dehydration. For an infant's condition to be improving, mucous membranes should be moist.

D. Fontanelle is level and soft. A level and soft fontanelle indicates that the infant is likely well-hydrated. Sunken fontanelles are a sign of dehydration, so this finding suggests improvement in the infant’s hydration status.

Administer sulfamethoxazole and trimethoprim: Anticipated

Sulfamethoxazole and trimethoprim (Bactrim) are commonly prescribed antibiotics for treating urinary tract infections, especially in children. They are effective against the bacteria commonly responsible for UTIs, such as Escherichia coli.

Administer salicylic acid for pain and fever: Contraindicated

Salicylic acid is not recommended for pain and fever management in children due to the risk of Reye's syndrome, a rare but serious condition that can occur in children recovering from viral infections, particularly after using salicylate-containing medications. Acetaminophen or ibuprofen are safer options for pain and fever relief in children with UTIs.

Educate the child about proper perineal hygiene. Anticipated

Proper perineal hygiene is essential for preventing recurrent urinary tract infections. Teaching the child about wiping from front to back after urination and bowel movements helps reduce the risk of introducing bacteria into the urinary tract.

Advise child's guardian about the use of sunscreen. Contraindicated

While sunscreen is important for protecting the skin from harmful UV rays, it is not directly related to the management of urinary tract infections. The priority should be on treating the infection and ensuring proper hygiene. Sunscreen advice may be relevant in general health discussions but is not specifically indicated for the current condition.

Ensure the child receives a maximum of 1,200 mL/day of fluid. Contraindicated

Adequate fluid intake is crucial for flushing out bacteria from the urinary tract and preventing dehydration. Restricting fluid intake to 1,200 mL/day may lead to concentrated urine, which can exacerbate urinary tract infections and increase the risk of complications. Encouraging adequate fluid intake, particularly water, is important for managing UTIs in children.