A pediatric home care nurse schedules a visit to the home of a 4-week-old newborn who had a low thyroxine (T4) and a high thyroid stimulating hormone (TSH) at birth, and was diagnosed with congenital hypothyroidism or cretinism. Which instruction is most important for the nurse to provide the parents of this child?

A. Serum blood glucose 185 mg/dL (10.2 mmol/L) (Incorrect): Although lower than the previous reading, it is still elevated, which can impair healing and increase the risk of infection recurrence.
B. Temperature 98.8°F (37.1°C) (Therapeutic Response): A return to a normal temperature indicates resolution of systemic infection. Fever is a sign of active infection, so its absence suggests improvement.
C. White blood cell count 11.2 x 10³/μL (11.2 x 10⁹/L) (Incorrect): This is slightly elevated, which may indicate residual inflammation or infection. A further decrease would be expected for full resolution.
D. Capillary refill greater than 3 seconds bilateral lower extremities (Incorrect): Delayed capillary refill suggests impaired circulation, which is not an indicator of a fully therapeutic response.
E. Bilateral lower extremities skin warm, dry, and pink (Therapeutic Response): Improved skin condition suggests reduced inflammation, better circulation, and healing of the cellulitis-affected area.
F. Pain 2 on a 0 to 10 pain scale, bilateral lower legs described as neuropathic (Therapeutic Response): Pain related to cellulitis typically improves with treatment. If the remaining pain is neuropathic, it suggests resolution of the acute infection.

A. Immediate allergic reaction mediated by sensitized mast cells. This describes a Type I hypersensitivity reaction, which is an immediate allergic reaction. It involves IgE antibodies and mast cell degranulation, leading to symptoms such as hives, anaphylaxis, and respiratory distress. Latex allergies can involve Type I reactions, but delayed hypersensitivity is a Type IV reaction.
B. Antigen-antibody complexes deposit in tissues activating inflammation. This describes a Type III hypersensitivity reaction, which involves immune complex deposition leading to inflammation, as seen in lupus or serum sickness. Latex allergies do not involve immune complex deposition.
C. T-cells sensitization initiates the macrophage release of cytokines causing a delayed reaction. This describes a Type IV hypersensitivity reaction, which is a delayed-type hypersensitivity (DTH) mediated by T-cells rather than antibodies. In latex-induced delayed hypersensitivity, T-cells recognize latex proteins and release cytokines, leading to localized skin inflammation, rash, and itching, typically 24–48 hours after exposure.
D. Antibodies are formed against antigens on cell surfaces. This describes a Type II hypersensitivity reaction, which involves antibody-mediated destruction of cells, as seen in hemolytic anemia or blood transfusion reactions. Latex allergies do not involve direct antibody attack on cells.