A nurse l monitoring an IV for a client who is to receive 120 mL of lactated Ringer's over 1 hr. The drip factor on the manual IV tubing is 15 gtt/mL. The nurse should ensure that the drip rate is set for how many gtt/min? (Round the answer to the nearest whole number. Use leading zero if it applies. Do not use a trailing zero.)

A) Completely undress the toddler:
Completely undressing a toddler can cause unnecessary distress and anxiety, especially if they are not prepared for the examination. It’s more appropriate to undress the toddler only as needed for the physical exam and allow them to remain clothed or partially clothed whenever possible to help them feel secure.

B) Allow the toddler to handle the equipment:
Allowing a toddler to handle the medical equipment is an excellent way to reduce fear and anxiety. This familiarizes the child with the instruments and allows them to feel more in control of the situation. It also helps in building trust with the nurse, making the examination less intimidating for the toddler.

C) Start the examination with routine immunizations:
Immunizations can be particularly stressful for toddlers, so starting the examination with vaccines is not the best approach. It’s better to begin with non-invasive procedures, such as listening to the heart or measuring the toddler’s height and weight, to build rapport before proceeding to any painful procedures.

D) Thoroughly explain each procedure to the toddler:
While it’s important to explain the examination to the toddler in simple, age-appropriate language, toddlers typically have a limited understanding of detailed explanations. Over-explaining may increase anxiety. Instead, it's better to keep things brief and comforting, using simple phrases, and focus on creating a positive experience.

A) Initiate droplet precautions: Respiratory syncytial virus (RSV) is primarily spread through contact with respiratory secretions, and droplet precautions are essential to prevent transmission. While RSV is commonly transmitted via direct contact or droplets, additional precautions like contact precautions may also be required, but droplet precautions should definitely be initiated as part of standard care to prevent the spread of the virus to others.

B) Monitor the preschooler’s urine for protein: Monitoring the urine for protein is not a standard action related to RSV. RSV is a respiratory virus, and its primary symptoms and complications involve the respiratory system, such as difficulty breathing, wheezing, or respiratory distress. There is no direct link between RSV and proteinuria, so this action is not necessary.

C) Administer fluconazole to the preschooler: Fluconazole is an antifungal medication, and it is not used to treat respiratory syncytial virus. RSV is a viral infection, so antiviral medications or supportive care like oxygen therapy, hydration, and possibly bronchodilators may be more appropriate. Fluconazole would not be appropriate for treating a viral infection like RSV.

D) Request an x-ray of the preschooler’s neck: An x-ray of the neck is generally not indicated for RSV unless there is a specific concern about airway obstruction or another condition like croup, which may present with symptoms similar to RSV. RSV primarily affects the lower respiratory tract, leading to symptoms like wheezing, cough, and difficulty breathing, not necessarily requiring a neck x-ray.