A nurse is reviewing potential provider orders for a client with respiratory syncytial virus (RSV). Which of the following orders should the nurse anticipate?

Choice A rationale

Adjustable crib rails pose a risk of mechanical failure and potential injury to infants. Current safety guidelines recommend fixed rails to eliminate entrapment hazards, ensuring the crib complies with modern safety standards.

Choice B rationale

Walkers with wheels are linked to a higher risk of falls and injuries in infants. These devices can inadvertently promote mobility before adequate muscle development, leading to instability and accidents. They are not recommended for injury prevention.

Choice C rationale

One-piece pacifiers with loop handles minimize choking risks by eliminating small parts that could detach. The loop handle ensures the pacifier can be easily retrieved, reducing the likelihood of airway obstruction in infants.

Choice D rationale

Placing a plastic covering underneath crib sheets increases the risk of suffocation and overheating. Safe sleep guidelines advocate for firm mattresses with fitted sheets only, avoiding any additional layers that compromise an infant's breathing environment. .

Choice A rationale

Taking the child for a walk in the hallway increases exposure to others and the risk of rubella transmission. Rubella is a contagious viral illness requiring droplet isolation precautions to prevent spreading. Walking in public spaces breaches infection control standards. Rubella symptoms include fever, rash, and swollen lymph nodes. Maintaining isolation reduces the risk of secondary infections, particularly in vulnerable populations like pregnant individuals, for whom rubella poses significant teratogenic risks.

Choice B rationale

Contacting a pregnant friend who visited before the rash appeared disregards rubella's incubation and transmission periods. Rubella is communicable 7 days before and up to 7 days after rash onset. Exposing pregnant individuals to rubella increases the risk of congenital rubella syndrome, leading to severe fetal complications. Understanding rubella’s contagious timeline ensures caregivers take necessary precautions to protect at-risk populations, emphasizing avoiding direct contact during infectious periods.

Choice C rationale

Keeping the child home for 7 days after rash disappearance adheres to rubella isolation guidelines. Rubella remains transmissible during and after rash presence, necessitating extended isolation to prevent community spread. Droplet precautions limit viral dissemination, particularly crucial around immunocompromised and pregnant individuals. Educating caregivers about prolonged isolation promotes effective infection control and minimizes public health risks associated with rubella outbreaks.

Choice D rationale

Keeping the child’s door closed when visiting does not adequately prevent rubella transmission. Droplet isolation requires mask use, restricted visitor access, and proper room ventilation. Closing the door alone fails to control airborne particles expelled during coughing or sneezing. Infection control measures prioritize reducing respiratory droplet spread, safeguarding household members and visitors from acquiring rubella.