A nurse is reinforcing teaching about receiving epinephrine as an emergency intervention for anaphylaxis. Which of the following information should the nurse reinforce with the client?

• Pneumonia: The preschooler is showing signs of shallow breathing, refusal to use the incentive spirometer, and slightly diminished breath sounds in the bilateral lower lobes, all of which increase the risk of developing pneumonia. Postoperative patients, especially young children, are vulnerable to pneumonia due to pain-limited deep breathing and poor pulmonary expansion.
• Wound infection: Although there is some serosanguinous drainage at the incision site, the dressing remains dry overall, and there is no mention of redness, warmth, or purulent discharge typically associated with wound infection. Therefore, wound infection is not the primary concern at this point.
• Ileus: Hypoactive bowel sounds are present, but they have been stable throughout the day without worsening abdominal distension or absence of bowel function. While ileus is a postoperative risk, the more pressing concern given the respiratory findings is pneumonia.
• Shallow breathing: The child consistently shows shallow, unlabored respirations throughout assessments, which indicate limited lung expansion. Without effective use of the incentive spirometer and adequate deep breathing, shallow breathing places the child at high risk for pulmonary complications such as pneumonia.
• Increasing temperature: Although the child's temperature rose slightly by 1600, it remains below 38° C (100.4° F), which is not typically classified as a fever. The minor temperature elevation could be related to inflammation rather than an infectious process at this stage.
• Hypoactive bowel sounds: Hypoactive bowel sounds are expected in the early postoperative period, particularly following abdominal surgery due to the effects of anesthesia and manipulation of the bowel during surgery. While they should be monitored, they are not the primary finding indicating the most urgent complication in this situation.

A: Image A shows an injection being prepared at the deltoid muscle, which is the correct site and technique for administering the tetanus and diphtheria (Td) vaccine. The Td vaccine should be given intramuscularly, typically into the deltoid muscle of the upper arm in adults, using a 90-degree angle to ensure proper muscle penetration.

B: Image B shows an injection technique appropriate for intradermal or possibly subcutaneous injection, indicated by the shallow angle of insertion into the skin. This method is not correct for a Td vaccine, which requires intramuscular administration for proper absorption and effectiveness.