A nurse is conducting discharge teaching to parents about the care of their infant after cardiac surgery. The nurse instructs the parents to notify the physician of what conditions occur. (Select all that apply.).

Choice A rationale:
Bronchoscopy is not the essential test for diagnosing cystic fibrosis. Bronchoscopy is a procedure that allows the healthcare provider to visualize the airways and lungs but is not the primary test for cystic fibrosis diagnosis. Cystic fibrosis is primarily diagnosed through genetic testing and sweat chloride testing.
Choice B rationale:
Serum calcium levels are not specific to cystic fibrosis diagnosis. Serum calcium levels are typically used to assess calcium balance in the body and are not directly related to cystic fibrosis diagnosis.
Choice C rationale:
Urine creatinine levels are not specific to cystic fibrosis diagnosis. Urine creatinine levels are often used to assess kidney function and muscle breakdown but are not diagnostic for cystic fibrosis.
Choice D rationale:
Sweat chloride test is essential in establishing the diagnosis of cystic fibrosis. Cystic fibrosis is characterized by the abnormal transport of chloride across cell membranes, leading to salty sweat. The sweat chloride test measures the amount of chloride in the sweat and is a key diagnostic test for cystic fibrosis. Values above a certain threshold (typically 60 mmol/L) are suggestive of cystic fibrosis.

Choice A rationale:

The first dose of the immunization for Measles, mumps, and rubella (MMR) is typically given at the age of 1 year. This timing is in line with the recommendations from organizations like the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). Administering the MMR vaccine at this age ensures early protection against these contagious diseases. Delaying the vaccine could put the child at risk, especially considering the highly infectious nature of measles.

Choice B rationale:

Administering the MMR vaccine at 18 months is not in line with the recommended immunization schedule. Waiting until 18 months might expose the child to the risk of contracting these diseases during the gap period, as maternal immunity wanes after the first few months of life.

Choice C rationale:

Administering the MMR vaccine at 2 years is later than the recommended age. Waiting until 2 years could leave the child vulnerable to these diseases during the time between birth and the administration of the vaccine. Early immunization, starting at 1 year, provides essential protection during this critical period.

Choice D rationale:

Waiting until 4 years to administer the MMR vaccine is not in line with the standard immunization schedule. Delaying the vaccine until 4 years of age leaves the child susceptible to these diseases for a more extended period, which is not recommended for preventing outbreaks and ensuring community immunity. The first dose of the immunization for Haemophilus influenzae type B (Hib) is given at the age of 2 months.