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

Given the child's recent motor vehicle accident and subsequent orthopedic surgeries, assessing the peripheral circulation is crucial. Comparing pedal pulses helps to determine the adequacy of blood flow to the lower extremities and identify any potential complications such as compartment syndrome. This assessment should be prioritized immediately.

While assessing pain, sedation level, and rechecking temperature are all important, they do not take precedence over assessing the child's circulation and perfusion status following major orthopedic surgeries.

A. The Tumbling E chart is a suitable tool for assessing visual acuity in young children who may not yet know their letters. It uses the letter "E" in various orientations (up, down, left, right), and the child is asked to identify the direction the "E" is facing. This method is appropriate for children who are at least 3 years old and can follow simple directions.
B. In a visual acuity assessment, it is typically standard to test each eye separately after assessing both eyes together. Testing both eyes together initially can help gauge how the child performs with their full visual capability, but it’s essential to test each eye individually to accurately determine if there is a difference in visual acuity between the two eyes.
C. For a visual acuity test using a standard Snellen chart, positioning the child 4.6 meters (15 feet) away from the chart is correct. However, younger children, especially those who might not be able to focus or remain still at that distance, may sometimes be tested from a shorter distance. For preschool-aged

children, the testing distance can be adapted to accommodate their ability to focus and understand the task.
D. Testing visual acuity without glasses first is not the recommended approach if the child already wears corrective lenses. If the child uses glasses or other corrective lenses, you should assess their visual acuity with the glasses on, as this provides the most accurate representation of their vision with their current correction.