A nurse is preparing a child for a lumbar puncture.
In which of the following positions should the child be placed for the procedure?

Choice A rationale

Washing the site with alcohol prior to applying the cream is not recommended. Alcohol can cause skin irritation and dryness, which may increase the discomfort during the procedure.

Choice B rationale

Rubbing the cream into the skin is not advised. The cream should be applied in a thick layer and not spread on the skin. Rubbing the cream can cause it to absorb into the skin too quickly and reduce its numbing effect.

Choice C rationale

Applying the cream 1 hour before the procedure is the correct action. Lidocaine and prilocaine cream should be applied at least 1 hour before the procedure to ensure adequate numbing of the skin.

Choice D rationale

The cream should not be left on the skin during the procedure. The healthcare provider will remove the cream just before the procedure. Leaving the cream on the skin could interfere with the procedure.

Choice A rationale

A child’s weight being in the 45th percentile is within the normal range and is not in itself an indicator of physical abuse.

Choice B rationale

Bruising around the wrists can be a potential indicator of physical abuse. Unexplained bruises, particularly in unusual locations or in specific patterns, can be a sign of physical abuse.

Choice C rationale

Abrasions on the knees are common in children due to normal play and activity and are not typically an indicator of physical abuse.

Choice D rationale

Missing front deciduous teeth in a 7-year-old student is not typically an indicator of physical abuse. It is normal for children to begin losing their deciduous (baby) teeth around this age.