A nurse is reinforcing teaching to the parents of a 6-year-old child who has fragile X-syndrome and is manifesting cognitive delays. Which of the following statements concerning coordination of care should the nurse reinforce?

Eczema (Atopic Dermatitis)

• Discomfort level: Pain 3/10 (more likely due to itching than infection)
• History of mosquito bites and prolonged scratching
• No fever (Temperature 37°C/98.6°F)
• Multiple scabs and lesions from scratching

Cellulitis

• Redness, warmth, and swelling on the left lower leg
• History of skin breakdown (scratching increases infection risk)
• Lesions present (Possible infection due to prolonged scratching)

Rationale:

Eczema (Atopic Dermatitis):

Eczema is a chronic inflammatory skin condition that causes itching, dryness, and irritation, often triggered by allergens or skin trauma. The child’s history of mosquito bites and excessive scratching aligns with eczema, as scratching worsens skin irritation and can lead to scabbed lesions. The absence of fever and a mild pain level (3/10) suggest this is primarily an inflammatory response rather than an infection.

Cellulitis:

Cellulitis is a bacterial skin infection that develops when bacteria enter through a break in the skin, often causing redness, warmth, swelling, and pain. The redness, warmth, and swelling on the left lower leg indicate possible early cellulitis, likely caused by bacteria introduced through scratching. However, the absence of fever and only mild pain suggest it may not be a severe infection yet.

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.