A school nurse is observing a child with ADHD who frequently leaves their seat, talks excessively, and interrupts peers.
What is the most appropriate intervention?

Choice A rationale

While spinal health is important at all ages, formal scoliosis screening typically does not begin as early as 6 years old. At this age, spinal curves are often subtle and may not be progressive, making mass screening less effective and potentially leading to overdiagnosis.

Choice B rationale

Screening at 14 years old might be too late for early detection and intervention in many cases, especially for girls who experience their growth spurt earlier. Untreated severe scoliosis can lead to significant spinal deformities and associated health issues.

Choice C rationale

Screening at 16 years old is generally past the peak growth spurt for most adolescents, meaning that any significant scoliotic curve would likely be well-established and more difficult to manage non-surgically. Early detection allows for more conservative treatment options.

Choice D rationale

Scoliosis screening is typically recommended to begin around 10 years old, especially for females, as this aligns with the onset of the adolescent growth spurt, during which scoliotic curves are most likely to progress rapidly. Early detection allows for timely intervention, such as bracing, to prevent severe curvature progression.

Choice A rationale

Notifying the healthcare provider immediately and requesting antibiotics is premature. Slight redness around pin sites without drainage or pain, and stable vital signs, does not immediately indicate a significant infection requiring systemic antibiotics. This initial finding warrants a thorough assessment and local care before escalating to medical intervention.

Choice B rationale

Removing crusting around pin sites can be detrimental. Crusting can serve as a protective barrier. Aggressive removal can introduce bacteria into the pin tract, increasing the risk of infection, or cause unnecessary pain and trauma to the delicate healing tissue. Gentle cleansing is preferred over forceful removal of adherent crusts.

Choice C rationale

Cleansing the pin sites using sterile saline and assessing for signs of infection is the best immediate action. Slight redness without drainage is often a normal inflammatory response to the foreign body and movement. Sterile saline effectively cleanses without irritating the tissue, and continued assessment helps monitor for evolving signs like increased redness, purulent drainage, or fever.

Choice D rationale

Documenting findings as normal and continuing routine assessments is insufficient. While slight redness can be normal, it still requires diligent monitoring and appropriate pin site care to prevent potential complications. Assuming normalcy without active intervention like cleansing could allow a minor irritation to progress to a more serious infection. .