A nurse is planning to apply a transdermal analgesic cream prior to inserting an IV for a preschool-age child. Which of the following actions should the nurse plan to take? (Select all that apply)

A. Erythema (redness) and edema (swelling) of the affected ear are classic signs of otitis media, an infection or inflammation of the middle ear. In otitis media, the middle ear becomes inflamed and fluid accumulates behind the eardrum, leading to redness and swelling of the tympanic membrane and surrounding tissues.
B. Tugging on the affected ear lobe is a common behavior observed in children with otitis media. Ear pulling or rubbing is often a sign of ear pain or discomfort, which can result from the pressure caused by the accumulation of fluid and inflammation in the middle ear.
C. Pain when manipulating the affected ear lobe is another common symptom of otitis media. Children with this condition may experience tenderness or discomfort when the affected ear is touched or manipulated due to the underlying inflammation and infection.
D. Clear drainage from the affected ear is not typically associated with otitis media. Instead, otitis media is characterized by the presence of middle ear effusion, which may manifest as fluid behind the eardrum. The drainage from otitis media is more commonly serous or purulent rather than clear.

A. Cleanse the skin prior to the procedure: Cleansing the skin before applying the transdermal analgesic cream is essential to remove any dirt, oils, or contaminants that could interfere with its absorption. This step helps ensure optimal drug delivery and effectiveness.
B. Apply the medication an hour before the procedure begins: Applying the transdermal analgesic cream an hour before the procedure allows sufficient time for the medication to be absorbed through the skin and reach its therapeutic effect. This timing ensures that the analgesic properties are in place when the IV insertion procedure starts.
C. Use a visual pain rating scale to evaluate the effectiveness of the treatment: Using a visual pain rating scale can help assess the child's pain level before and after applying the transdermal analgesic cream. This evaluation provides valuable feedback on the cream's effectiveness in providing pain relief.
D. Apply to intact skin: Transdermal medications are designed to be absorbed through intact skin. Applying the cream to intact skin ensures proper absorption and effectiveness of the analgesic medication.
E. Spread the cream over the lateral surface of both forearms. This option might not be necessary or appropriate for the intended purpose. The choice of application site for transdermal analgesic cream depends on the specific medication and the area of pain. While the lateral surface of the forearms can be a suitable site, it may not always be necessary or feasible to apply the cream to both forearms, especially if the intended IV insertion site is on one arm.