A nurse is teaching a parent of a preschool-age child about management of sleep terrors. Which of the following instructions should the nurse include?

A. Auscultate the abdomen for at least 1 min if bowel sounds are absent. This is an appropriate action. Absence of bowel sounds can indicate a serious condition, so the nurse should auscultate for at least 1 minute to confirm their absence. However, it is generally recommended to listen for up to 5 minutes before concluding that bowel sounds are absent.

B. Use the bell stethoscope to auscultate breath sounds. The diaphragm of the stethoscope, not the bell, is typically used to auscultate breath sounds because it is better at picking up higher-pitched sounds like those of the lungs.

C. Check visual acuity by using the tumbling E eyechart. The tumbling E chart is appropriate for pre-schoolers who may not know the alphabet. This chart helps assess visual acuity in young children by having them identify the direction of the E's legs.

D. Place hand on the pre-schooler’s abdomen to determine respiratory rate. Placing a hand on the abdomen can help in counting the respiratory rate in infants and very young children who are diaphragmatic breathers, but for pre-schoolers, it is typically easier and more accurate to count respirations by observing the chest rise.

A. "You should use a mild detergent for your child's laundry.": Correct. Using a mild detergent helps to minimize irritation and sensitivity, especially for children with skin conditions like eczema, which may benefit from pimecrolimus cream.
B. "You can apply gloves to your child's hands.": Correct. Applying gloves can prevent scratching and further irritation to the skin, especially if the child has lesions or eczema on their hands.
C. "You should cut and file your child's fingernails frequently.": Correct. Keeping the child's fingernails short and filed can prevent accidental scratching and trauma to the skin, reducing the risk of exacerbating skin lesions.
D. "You should apply emollients to your child's skin after bathing.": Correct. Emollients help to moisturize the skin and prevent dryness, which can be beneficial for children with skin conditions like eczema. Applying emollients after bathing helps to lock in moisture.
E. "You should apply a thick layer of pimecrolimus cream to your child's lesions.": Incorrect. Pimecrolimus cream should be applied in a thin layer to the affected skin areas, as directed by the healthcare provider. Using a thick layer may not improve efficacy and could increase the risk of side effects.
F. "Your child's condition is contagious when lesions are present.": Correct. It's important for the guardian to understand that certain skin conditions, such as eczema, may not be contagious themselves but can become infected if lesions are present and scratched, leading to bacterial or viral infections.
G. "Your child will experience occasional flare-ups of this condition.": Correct. Skin conditions like eczema often have a chronic and relapsing course, with periods of exacerbation (flare-ups) and remission. Providing this information helps the guardian understand the chronic nature of the condition and the need for ongoing management and monitoring.