A nurse is teaching the parent of an infant about car seat safety. Which of the following instructions should the nurse include?

A. Limiting the child’s fluid intake following the procedure is not necessary. Instead, encouraging oral fluids helps restore CSF volume and reduces the risk of post-lumbar puncture headache. Restricting fluids can worsen dehydration and delay recovery.

B. Positioning should not be prone during the procedure. The correct position is lateral recumbent with knees flexed to the chest or sitting with the head flexed. This widens the spaces between the vertebrae, allowing safe needle insertion into the subarachnoid space.

C. A signed consent form from the guardian is essential before a lumbar puncture. This ensures legal and ethical compliance, as the procedure is invasive and carries risks such as bleeding, infection, or spinal injury. The nurse must verify consent before proceeding.

D. Inserting an indwelling urinary catheter is not part of lumbar puncture preparation or procedure. Catheterization introduces unnecessary infection risk and is unrelated to collecting cerebrospinal fluid or managing patient safety during the test.

E. Applying pressure to the puncture site is required after needle withdrawal to reduce the risk of bleeding and CSF leakage. Maintaining pressure for several minutes supports clot formation and helps prevent complications such as hematoma.

F. Having the child void prior to the procedure is important for comfort and safety. The lumbar puncture may take time, and a full bladder can cause discomfort, interfere with positioning, or increase risk of accidental urine leakage during the test.

G. Monitoring for paresthesia or tingling after the procedure is crucial. These symptoms can indicate nerve irritation or trauma during needle insertion. Early detection allows prompt reporting and further evaluation to prevent long-term neurological complications.

A. Paroxysmal coughing: This is most characteristic of pertussis (whooping cough), not rubeola (measles). Rubeola is primarily identified by fever, cough, coryza, conjunctivitis, and a distinct rash.

B. Koplik spots: Small, white lesions with a bluish center inside the mouth are pathognomonic for rubeola. They usually appear 2–3 days before the rash and are a key diagnostic feature of the disease.

C. Lymphadenopathy: While enlarged lymph nodes can occur with various viral illnesses, it is not a defining or expected feature of rubeola. The hallmark oral and skin findings are more specific.

D. Steatorrhea: Fatty, foul-smelling stools are associated with malabsorption syndromes such as cystic fibrosis or celiac disease. They are not linked to rubeola infection.