A school-aged child is admitted to the hospital with a diagnosis of acute rheumatic fever. In obtaining a health history from the child's parent, the recent occurrence of which illness is most significant?

Choice A reason: Taking the child to a hair salon for a shampoo and a shorter haircut is not a good instruction that the nurse should provide. This is because a hair salon may not accept a child with head lice, as they can spread to other customers and staff. A shorter haircut may also not help to get rid of the lice or their eggs, which can attach to any length of hair.

Choice B reason: Rewashing the child's hair following a 24-hour isolation period is not a good instruction that the nurse should provide. This is because a 24-hour isolation period is not necessary or effective for treating head lice. Head lice do not survive long without a human host, and they do not spread through the air or by jumping. Rewashing the child's hair may also wash off the permethrin shampoo, which needs to stay on the hair for 10 minutes to kill the lice and their eggs.

Choice C reason: Washing the child's bed linens and clothing in hot soapy water is a good instruction that the nurse should provide. This is because head lice and their eggs can be transferred to the child's bedding and clothing through direct contact. Washing these items in hot water (at least 130°F or 54°C) and drying them on high heat can kill any remaining lice or eggs. Alternatively, the items can be sealed in plastic bags for two weeks to suffocate the lice.

Choice D reason: Disposing of the child's brushes, combs, and other hair accessories is not a good instruction that the nurse should provide. This is because it is not necessary to throw away these items, as they can be treated and reused. The nurse should advise the parents to soak the items in hot water (at least 130

Choice A reason: Autonomy is not the stage of Erikson's theory of psychosocial development that the nurse is addressing when teaching this client about insulin injections. Autonomy is the stage that occurs from 18 months to 3 years of age, when the child develops a sense of independence and self-control. The conflict in this stage is between autonomy and shame and doubt. The nurse may address this stage when teaching the client's parents about how to support their child's autonomy and avoid overprotection or criticism.

Choice B reason: Identity is not the stage of Erikson's theory of psychosocial development that the nurse is addressing when teaching this client about insulin injections. Identity is the stage that occurs from 12 to 18 years of age, when the adolescent develops a sense of self and personal identity. The conflict in this stage is between identity and role confusion. The nurse may address this stage when teaching the client about how to cope with the psychosocial challenges of having a chronic condition and how to maintain a positive self-image and self-esteem.

Choice C reason: Industry is the stage of Erikson's theory of psychosocial development that the nurse is addressing when teaching this client about insulin injections. Industry is the stage that occurs from 6 to 11 years of age, when the child develops a sense of competence and achievement. The conflict in this stage is between industry and inferiority. The nurse may address this stage when teaching the client about how to manage their diabetes and how to acquire the skills and knowledge needed for self-care and health promotion.

Choice D reason: Initiative is not the stage of Erikson's theory of psychosocial development that the nurse is addressing when teaching this client about insulin injections. Initiative is the stage that occurs from 3 to 6 years of age, when the child develops a sense of initiative and creativity. The conflict in this stage is between initiative and guilt. The nurse may address this stage when teaching the client about how to express their feelings and opinions about their diabetes and how to participate in decision-making and problem-solving.