A nurse is teaching a parent of a 10-month-old infant about home safety. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

A. Feels alienated from their friends: Preschoolers typically do not have a fully developed understanding of illness or death, so feelings of alienation from friends are not an expected developmental response. Their social awareness is limited, and they are more focused on immediate experiences than abstract concepts like mortality.

B. Understands that death is inevitable: Preschoolers generally lack the cognitive development to grasp the permanence of death. They often view death as reversible or temporary, so expecting them to understand its inevitability does not align with typical developmental stages.

C. Believes that death is temporary: At the preschool age, children often see death as a temporary state, similar to sleeping or going away. This belief is consistent with their developmental stage and limited understanding of abstract concepts such as life and mortality.

D. Expresses anxiety about physical changes: While some preschoolers may notice physical changes related to illness, their understanding of these changes is limited, and they are unlikely to articulate anxiety about bodily transformations in the context of terminal illness. Their concerns are more concrete and immediate.

A. "I will take my child's pulse for 30 seconds before giving the medication.": Checking the pulse for 1 full minute is crucial before administering digoxin, especially in preschool-age children, because the medication can slow the heart rate. If the pulse is below the prescribed threshold (usually <90–100 bpm in young children), the dose should be held.

B. "I will mix the medication in a glass with 4 ounces of orange juice.": Digoxin can be given with a small amount of liquid, but large volumes of juice are not recommended because excessive liquid may make it difficult for the child to take the full dose. Also, certain juices may interact with absorption; using a small amount of water or juice is safer.

C. "I will repeat the dose if she vomits after taking the medication.": Repeating a dose after vomiting is unsafe because it can result in digoxin toxicity, especially in young children. The parent should contact the healthcare provider for guidance instead of administering a second dose.

D. "I will tell my child to brush her teeth after she takes this medication.": Digoxin elixir is prepared in a high-sugar syrup base to make it more palatable for children. Frequent administration of this sticky, sugary liquid can lead to tooth decay and dental carries. Brushing the teeth (or rinsing the mouth in younger infants) after each dose is an essential measure.