A nurse is providing teaching to the guardians of an infant who require a pavlik harness.
Which instructions should the nurse include?

Choice A rationale

A rectal body temperature of 37.3 C (99.1 F) in a school-age child is within the normal range, so it does not need to be reported.

Choice B rationale

A heart rate of 68/min in an 18-month-old toddler is below the normal range (80-130 beats per minute). This could indicate a serious condition such as heart block or hypothermia and should be reported to the provider.

Choice C rationale

A blood pressure of 132/82 mm Hg in an adolescent is slightly elevated but within acceptable limits for a teenager, especially if the teenager was nervous or anxious during the measurement.

Choice D rationale

A respiratory rate of 36/min in a 3-month-old infant is within the normal range (30-60 breaths per minute), so it does not need to be reported.

Choice A rationale

The human papillomavirus (HPV) vaccine is not typically given at 12 months of age. It is usually administered to adolescents.

Choice B rationale

The inactivated polio virus vaccine is not typically given at 12 months of age. It is usually administered earlier in infancy.

Choice C rationale

The hepatitis B vaccine is not typically given at 12 months of age. It is usually administered shortly after birth and in the first few months of life.

Choice D rationale

The varicella vaccine, which protects against chickenpox, is typically given at 12 months of age.