A nurse is providing peritoneal dialysis to a child and observes there is minimal dialysate outflow at the end of the outflow time. Which of the following actions should the nurse take?

A. The Hepatitis B vaccine is typically administered in a series of three doses, starting at birth and continuing through the first year of life. By the age of 5, the child should already have completed the Hepatitis B series. Therefore, this vaccine is not usually administered at this age unless there is a missed dose or special circumstances requiring catch-up.
B. The Hib vaccine is given in a series during infancy and early childhood, with the last dose typically administered between 12 and 15 months of age. By the age of 5, most children should have completed the Hib series. Like Hepatitis B, Hib would not generally be administered at this age unless there are specific catch-up needs.
C. The Varicella (chickenpox) vaccine is part of the routine immunization schedule for children. The first dose is typically given between 12 and 15 months of age, and the second dose is administered between 4 and 6 years of age. At 5 years old, the child would be due for the second dose of the Varicella vaccine if not already received. This makes it a relevant immunization for this age group.
D. The Rotavirus vaccine is given in a series to infants, starting at 2 months of age, with subsequent doses typically given at 4 and 6 months. The series should be completed before the child is 8 months old. By age 5, the child should have already completed the Rotavirus series, so this vaccine would not be administered at this age.

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.