A nurse is planning care for a toddler who has developed oral ulcers in response to chemotherapy. Which of the following actions should the nurse include in the plan of care?

Choice A Reason:

Encourage frequent physical activity to increase bone mass: While physical activity is generally beneficial for overall health, in the case of osteomyelitis, encouraging excessive or frequent physical activity might exacerbate pain, discomfort, and the risk of further bone injury. Controlled and appropriate physical activity may be recommended, but it should be individualized based on the child's condition and the affected area.

Choice B Reason:

Provide a high-calorie, low-protein diet: In osteomyelitis, a balanced and nutritious diet is important to support the child's overall health and aid in recovery. However, a high-calorie, low-protein diet would not be suitable for combating infection or supporting healing. Adequate protein intake is essential for tissue repair and immune function.

Choice C Reason:

Initiate contact precautions for the child: Osteomyelitis is not typically transmitted from person to person. It's an infection within the bone that doesn't require contact precautions for prevention of spread among individuals. Treatment primarily involves antibiotics and sometimes surgical drainage, but it doesn't necessitate isolation precautions.

Choice D Reason:

Maintain a patent intravenous catheter: Antibiotics are the mainstay of treatment for osteomyelitis, and they are usually administered intravenously for an extended period to effectively eradicate the infection. Maintaining a patent intravenous catheter ensures continuous access for medication administration.

A. "Postpone burping the infant until after completing each feeding."Burping should not be postponed. Infants with a cleft palate may have more difficulty with feeding and may need to be burped more frequently to reduce the risk of aspiration and discomfort.

B. "Feed the infant 177.4 ml. (6 oz) of formula three times each day."The amount and frequency of feeding should be individualized based on the infant's needs and growth patterns. Typically, an infant with a cleft palate requires more frequent, smaller feedings, and the total volume needs to be adjusted according to their specific nutritional needs.

C. "Discontinue a feeding if the infant's eyes become watery."Watery eyes during feeding can be a sign of aspiration or feeding difficulties. If this occurs, it is important to stop the feeding and assess the situation, as it may indicate that the infant is not handling the feeding well and could be at risk for aspiration or other complications.

D. "Elevate the infant's head to a 10° angle during feedings."A 10° angle may be too shallow to effectively prevent aspiration. Typically, the head should be elevated to a greater degree, often 30-45°, to help facilitate safer feeding and reduce the risk of aspiration in infants with a cleft palate.