A nurse is providing care for a 6-year-old patient who was admitted due to dehydration following a tonsillectomy 26 hours ago.
The patient's vital signs are as follows: Temperature: 100.9°F, Pulse: 150 bpm (apically), Respiration: 28, Blood Pressure: 88/50, Pain: Ears 0, Throat 10 using FACES pain scale, Weight: 40 lbs.
Complete the following sentence by using the list of options as evidenced by: The patient is most at risk for:

Choice A rationale

An average daily intake of about 3,000 calories is too high for a toddler. The recommended caloric intake for a toddler varies depending on age, size, and activity level, but it is generally much lower than 3,000 calories.

Choice B rationale

“The quality of food I provide him is more important than the quantity.”. This statement indicates an understanding of the teaching. It’s important to focus on providing nutrient-dense foods rather than just a large quantity of food.

Choice C rationale

Expecting an increased appetite in a toddler is not necessarily accurate. Toddlers often have variable appetites and may eat well one day and eat very little the next.

Choice D rationale

Giving a toddler an adult vitamin is not recommended. Toddlers have different nutritional needs than adults, and some vitamins and minerals can be harmful in large amounts. It’s better to focus on providing a balanced diet.

The nurse should include the following information in the teaching about home safety for a 10- month-old infant:

1. Keep plastic bags and plastic grocery bags in a secure place. Plastic bags pose a choking hazard for young children who can easily put them over their heads and suffocate.
2. Serve food in small pieces no larger than a cheerio. This reduces the risk of choking, as infants have limited chewing ability and can easily swallow large pieces of food whole.

E. Use plastic covers on all electrical outlets. This prevents the infant from sticking fingers or objects into the outlet, which could lead to electrical shock.

However, the following information is incorrect and should not be included:

C. Lower the crib rails to the lowest level. While lowering the crib rails might seem convenient, it actually increases the risk of the infant climbing out and potentially falling and injuring themselves. Crib rails should be kept at the highest level possible once the infant can sit up on their own.

D. Set the water heater to 65°C (149°F). This temperature is scalding hot and can cause severe burns in infants. The recommended safe water heater temperature is 120°F (48.9°C) or lower to prevent accidental scalding.

Therefore, the correct selections are A, B, and E. The nurse should emphasize the importance of creating a safe environment for the infant by keeping choking hazards out of reach, serving food in appropriate sizes, and preventing access to electrical outlets. Additionally, the nurse should educate parents about the safe water heater temperature to avoid scalding risks.