A nurse is planning care for a child who has mumps. Which of the following instructions should the nurse include in the plan?

Choice A: Smiling when a parent appears is not a manifestation of cerebral palsy, but rather a normal developmental milestone that indicates social and emotional development. An 8-month-old infant should be able to smile spontaneously and responsively at familiar people.

Choice B: Using a pincer grasp to pick up a toy is not a manifestation of cerebral palsy, but rather a normal developmental milestone that indicates fine motor development. An 8-month-old infant should be able to use their thumb and index finger to pick up small objects.

Choice C: Sitting with pillow props, cannot sit independently is a manifestation of cerebral palsy, which is a condition that causes impaired movement and posture due to brain damage or abnormal development. An 8-month-old infant should be able to sit without support and maintain balance. Sitting with pillow props, cannot sit independently indicates poor muscle tone, strength, or coordination.

Choice D: Tracking an object with eyes is not a manifestation of cerebral palsy, but rather a normal developmental milestone that indicates visual development. An 8-month-old infant should be able to follow an object or person with their eyes in all directions.

Choice A:In actual practice, log rolling is typically done every 2 hoursto align with standard nursing protocols for preventing complications such as pressure injuries, maintaining skin integrity, and ensuring patient comfort. Repositioning every 2 hours also helps promote better circulation and reduces the risk of complications like pneumonia and deep vein thrombosis (DVT).
as a unit without twisting or bending the spine. The nurse should use a draw sheet and at least two other staff
members to assist with log rolling.

Choice B: This intervention is incorrect, as keeping the head of the bed at a 30-degree angle can cause flexion of the spine and compromise spinal alignment. The head of the bed should be kept flat or slightly elevated, depending on the provider's orders and the client's comfort. The nurse should avoid raising or lowering the head of the bed without checking with the provider first.

Choice C: This intervention is unnecessary, as placing the client in protective isolation is not indicated for a client who is postoperative following scoliosis repair with Harrington rod instrumentation. Protective isolation is used for clients who have compromised immune systems and are at high risk of acquiring infections from others, such as transplant recipients, cancer patients, or patients receiving immunosuppressive therapy. The nurse should follow standard precautions and surgical site care to prevent infection in this client.

Choice D: This intervention is optional, as initiating the use of a PCA pump for pain control may or may not be appropriate for a client who is postoperative following scoliosis repair with Harrington rod instrumentation. A PCA pump is a device that allows the client to self-administer a preset dose of analgesic medication by pressing a button. A PCA pump can provide effective and individualized pain relief, but it requires careful monitoring and education. The nurse should assess the client's pain level, preference, and ability to use a PCA pump and consult with the provider before initiating it.