A nurse is teaching about safety recommendations for car seats with the parents of a 24-month- old toddler who is in the 50th percentile for height and weight. Which of the following instructions should the nurse include in the teaching?

To calculate the appropriate dosage of amoxicillin for the toddler; Given:

Weight of the toddler = 20 kg

Recommended dosage range = 20 to 25 mg/kg/day Calculate the total daily dose:

Minimum recommended dosage = 20 mg/kg/day Maximum recommended dosage = 25 mg/kg/day

Minimum total daily dose = 20 mg/kg/day × 20 kg = 400 mg/day Maximum total daily dose = 25 mg/kg/day × 20 kg = 500 mg/day

The prescribed dosage is 100 mg every 8 hours, which means 300 mg per day (100 mg × 3 times a day). As 300 mg is below the minimum recommended total daily dose (400 mg) for a toddler weighing 20 kg, the nurse should determine that the prescribed dosage is insufficient to achieve the desired effect.

Turning and repositioning the client at regular intervals is essential for preventing pressure ulcers in pediatric clients, especially those in the PICU who may be immobilized or have limited mobility due to their condition or treatment. Repositioning helps relieve pressure on bony prominences and redistributes pressure on the skin, reducing the risk of pressure ulcers. Turning schedules should be individualized based on the child's condition, mobility, and risk factors for pressure ulcers.

A. Avoid the use of a draw sheet when turning: Using a draw sheet can facilitate safe and smooth turning of the client without causing shear or friction forces. It helps distribute the weight evenly and reduces the risk of injury to the client or caregiver during the turning process. Therefore, avoiding the use of a draw sheet may increase the risk of pressure ulcers rather than prevent them.
B. Post a turning schedule at the client's bedside: While posting a turning schedule may serve as a reminder for staff, it alone does not provide direct intervention to prevent pressure ulcers. The crucial aspect is implementing the turning schedule consistently and ensuring that the client is repositioned at appropriate intervals.
C. Vigorously massage lotion into bony prominences: Massaging lotion into bony prominences can increase friction and shear forces on the skin, potentially causing tissue damage rather than preventing pressure ulcers. Additionally, vigorous massage may be uncomfortable or painful for the client, especially if they have fragile skin or existing pressure ulcers.