A nurse is providing care to a child who has Down syndrome during a well-child checkup. Which of the following assessment findings requires immediate follow-up by the nurse?

A. Provide frequent and routine verbal updates with the parents. Regular updates help reduce parental anxiety and build trust between the healthcare team and the family. Keeping parents informed reassures them that their child is receiving appropriate care.

B. Encourage the parents to participate in the toddler's plan of care when appropriate. Involving parents in simple caregiving tasks (e.g., soothing the child, assisting with feedings) fosters a sense of control and connection, easing their distress.

C. Perform more frequent health care rounds on the toddler. Increased monitoring ensures early detection of respiratory complications and reassures parents that their child's condition is being closely managed.

D. Conduct interprofessional rounds at the child's bedside so the parents can be included. Including parents in bedside rounds allows them to hear updates from multiple specialists, ask questions, and feel more engaged in decision-making regarding their child's care.

E. Reinforce education to the parents on all nursing interventions to alleviate added anxiety about tasks they are unfamiliar with. While educating parents is important, overwhelming them with detailed explanations of every intervention may actually increase anxiety rather than alleviate it. Teaching should be concise and tailored to what the parents need to know at the moment.

F. Provide the parents with the nurse's personal cell phone number to contact if they have questions while they are away from the hospital. Personal phone numbers should not be given out for professional and ethical reasons. Instead, parents should be provided with the hospital unit’s contact information for any concerns.

A. Warm the medication container for 10 seconds in a microwave oven prior to instillation. Using a microwave to warm ear drops is unsafe, as it can cause uneven heating and potentially burn the delicate ear structures. Instead, the medication should be warmed by holding the container in the hands for a few minutes.

B. Apply clean gloves and clean the outer ear prior to instilling drops. Wearing gloves prevents contamination, and cleaning the outer ear removes purulent drainage, ensuring the medication reaches the ear canal properly. This is an essential step in infection control and medication effectiveness.

C. Firmly push a cotton ball into the ear canal after instilling drops. Inserting a cotton ball too firmly can trap moisture and bacteria, potentially worsening the infection. If needed, a loosely placed cotton ball may be used, but it should not be forced into the canal.

D. Pull the child's ear auricle upward and outward just before instilling drops. This technique is used for adults and children over 3 years old. In a 2-year-old, the correct method is to pull the auricle downward and back to straighten the ear canal for proper medication administration.