A nurse is reinforcing teaching with another nurse about how change an ostomy appliance for a client who has sigmoid colostomy. Which of the following instructions should the nurse include in the teaching?

A) Completely undress the toddler:
Completely undressing a toddler can cause unnecessary distress and anxiety, especially if they are not prepared for the examination. It’s more appropriate to undress the toddler only as needed for the physical exam and allow them to remain clothed or partially clothed whenever possible to help them feel secure.

B) Allow the toddler to handle the equipment:
Allowing a toddler to handle the medical equipment is an excellent way to reduce fear and anxiety. This familiarizes the child with the instruments and allows them to feel more in control of the situation. It also helps in building trust with the nurse, making the examination less intimidating for the toddler.

C) Start the examination with routine immunizations:
Immunizations can be particularly stressful for toddlers, so starting the examination with vaccines is not the best approach. It’s better to begin with non-invasive procedures, such as listening to the heart or measuring the toddler’s height and weight, to build rapport before proceeding to any painful procedures.

D) Thoroughly explain each procedure to the toddler:
While it’s important to explain the examination to the toddler in simple, age-appropriate language, toddlers typically have a limited understanding of detailed explanations. Over-explaining may increase anxiety. Instead, it's better to keep things brief and comforting, using simple phrases, and focus on creating a positive experience.

A) You should avoid exercising for the next 6 weeks:
This statement is not accurate. The client is encouraged to gradually increase activity and participate in physical therapy as prescribed to improve mobility and strength following a total hip arthroplasty. While some rest and limited activity may be necessary immediately after surgery, complete avoidance of exercise for six weeks is generally not advised unless there are complications. Physical therapy exercises are often a key component in the recovery process after hip replacement surgery.

B) You should avoid lying on your right side:
This recommendation is incorrect unless specifically contraindicated due to complications. After a right total hip arthroplasty, the client can typically lie on either side once they are comfortable, unless instructed otherwise by the healthcare provider. It is important to follow the surgical instructions regarding positioning, especially avoiding positions that might place stress on the new joint

C) You should avoid putting a pillow between your legs when in bed:
This statement is incorrect. After a total hip arthroplasty, placing a pillow between the legs when lying on either side is recommended to maintain proper alignment of the hip joint and prevent dislocation. The pillow helps keep the legs slightly apart, preventing the hip from rotating inward, which can put the new joint at risk for dislocation.

D) You should avoid crossing your legs formonths:
This is correct. Following a total hip arthroplasty, it is essential to avoid crossing the legs, especially for the first several months. Crossing the legs can lead to hip dislocation or improper alignment of the joint. The nurse should reinforce the importance of avoiding crossing the legs both while sitting and lying down to ensure proper healing and to avoid complications such as dislocation of the new hip joint.