A nurse is planning care for an adolescent who has sickle cell anemia.
Which of the following immunizations should the nurse include in the plan?

Choice A rationale:

Contacting the client's parents for phone consent might breach the adolescent's confidentiality, especially if they are seeking STI testing. In many jurisdictions, adolescents have the right to confidential healthcare, including STI testing and treatment, without parental consent. Respecting the adolescent's autonomy and confidentiality is crucial in this situation.

Choice B rationale:

Obtaining written consent from the client, if they are of legal age (which is often 16 or older in many jurisdictions), is appropriate and respects the adolescent's autonomy and legal rights. Written consent ensures that the adolescent fully understands the tests being conducted and gives informed consent for the procedure.

Choice C rationale:

Requesting verbal consent from the social worker is not appropriate. Verbal consent can be ambiguous and may not provide sufficient legal documentation of informed consent, especially for sensitive procedures like STI testing.

Choice D rationale:

Postponing the testing until the client's parents are present might not be in the best interest of the adolescent, especially if they are seeking timely healthcare. Delays in testing and treatment could lead to complications or the spread of STIs. Respecting the adolescent's autonomy and providing appropriate, timely care is essential in this situation.

Answer is A. Use a 24-gauge catheter to start the IV.

A 24-gauge catheter is the smallest and most appropriate size for an infant's vein¹. It reduces the risk of infiltration, phlebitis, and thrombosis².

B. Start the IV in the infant's foot. Statement is wrong because starting the IV in the foot can interfere with the infant's mobility and increase the risk of infection³. The preferred sites for IV insertion in infants are the scalp, hand, or arm veins⁴.

C. Change the IV site every 3 days. Statement is wrong because changing the IV site every 3 days is not recommended for infants and children. The IV site should be changed only when clinically indicated, such as signs of infection, infiltration, or phlebitis.

D. Cover the insertion site with an opaque dressing. Statement is wrong because covering the insertion site with an opaque dressing can obscure the visibility of the site and prevent early detection of complications. A transparent dressing is preferred as it allows for continuous assessment of the site.