A school nurse is preparing to support children who have a chronic illness in a middle school setting. The nurse should be aware of which of the following challenges chronically a children may face? (Select All that Apply)

A. Administering the insulin injection quickly to minimize discomfort. Administering an injection quickly may reduce discomfort, but it does not address the emotional and psychological aspects of atraumatic care. The goal is to minimize fear and distress, not just physical pain.

B. Explaining the procedure in simple terms to the client before administering the insulin. Providing a clear, age-appropriate explanation helps reduce anxiety and fosters trust between the child and the nurse. Understanding what to expect allows the child to feel a sense of control, which is a key principle of atraumatic care.

C. Asking the client to look away during the injection to reduce anxiety. While looking away may help some children, it does not promote understanding or involvement in their care. Instead, explaining the procedure allows the child to develop coping strategies and feel more secure.

D. Using a larger needle to ensure accurate insulin delivery. Insulin is administered using a small-gauge needle to minimize pain. A larger needle is unnecessary and could increase discomfort, contradicting the principles of atraumatic care.

A. "Diaper dermatitis is always associated with an infection." Diaper dermatitis is most commonly caused by prolonged exposure to moisture, urine, or feces, leading to skin irritation. While secondary infections (e.g., Candida albicans) can develop, not all cases are infectious.

B. "Diaper dermatitis requires immediate assessment by a medical provider." Most cases of diaper dermatitis can be managed at home with frequent diaper changes, barrier creams (such as zinc oxide), and keeping the area dry. Medical evaluation is only necessary if the rash worsens, does not improve, or shows signs of infection (e.g., pustules, severe redness, fever).

C. "Diaper dermatitis causes significant long-term impacts." Diaper dermatitis is temporary and does not cause long-term effects when properly treated. Severe, untreated cases may lead to discomfort and secondary infections, but lasting damage is rare.

D. "Diaper dermatitis will respond to prompt treatment." This is correct. Frequent diaper changes, exposure to air, and application of barrier creams typically resolve mild to moderate diaper dermatitis within a few days.