A nurse is reinforcing teaching with the parent of a toddler about promoting effective sleep patterns. Which of the following statements by the parent indicates an understanding of the teaching?

Rationale:

A) Morning stiffness in the joints is a common symptom of juvenile idiopathic arthritis and is expected in this client population. It does not require immediate reporting to the provider.

B) Taking a multivitamin containing iron is generally not concerning and may even be beneficial for clients with arthritis who may have dietary deficiencies. It does not require immediate reporting to the provider.

C) The presence of blood in the stool may indicate gastrointestinal bleeding, a potential adverse effect of long-term ibuprofen use. This symptom should be reported to the provider promptly for further evaluation.

D) Skipping ibuprofen doses occasionally, particularly if the client missed one dose, may not be concerning unless it becomes a pattern of non-compliance. It does not require immediate reporting to the provider, although it should be addressed during routine follow-up.

Rationale:

A) A hemangioma is a benign vascular tumor commonly found in infants and is not indicative of physical maltreatment.

B) A burn with splash marks, especially in a patterned distribution, raises suspicion of physical abuse and should be reported immediately for further evaluation.

C) A large, irregular, brownish-blue area on the infant's buttock may indicate bruising, but further assessment is needed to determine the cause.

D) An abrasion on the back of the infant's arm may be due to accidental injury and does not necessarily indicate physical maltreatment, although it warrants further assessment and documentation.