A single woman brings her 10-year-old daughter in for the first well-child visit at the clinic. The nurse discovers they recently relocated to that area due to the mother’s job, the child is now attending a “tough” school and she is home, scared and alone, for several hours after school. Which action should the nurse prioritize to assist this family?

Choice A reason: Holding the buttocks together for 1-2 minutes after suppository insertion prevents expulsion, ensuring the medication is absorbed in a 3-month-old. This aligns with pediatric medication administration protocols, making it the correct intervention to assure effective delivery of the rectal suppository in this infant.

Choice B reason: Pre-warming the suppository is not standard, as it may soften excessively, complicating insertion. Holding the buttocks ensures retention, directly impacting absorption, making this less effective and incorrect compared to the critical step of preventing expulsion in a 3-month-old during suppository administration.

Choice C reason: Using the index finger is inappropriate for an infant, as the pinky finger is safer for their small rectum. Holding the buttocks ensures medication retention, making this unsafe and incorrect compared to the prioritized intervention for effective suppository administration in a 3-month-old child.

Choice D reason: Placing the child on the abdomen may aid positioning but does not ensure suppository retention like holding the buttocks. Retention is critical for absorption, making this less essential and incorrect compared to the direct intervention of securing the suppository in place post-insertion for the infant.

Choice A reason: Rubbing the nose upward and backward, known as the "allergic salute," is a common response in allergic rhinitis to relieve nasal itching and congestion. This action temporarily opens air passages and alleviates discomfort, aligning with pediatric allergy evidence, making it the correct explanation for the child’s behavior observed in clinical settings.

Choice B reason: Drawing attention to the nose is not a typical response in allergic rhinitis. The "allergic salute" is a reflexive action to relieve itching and congestion, not a deliberate attempt to gain attention. This choice misinterprets the physiological basis of the behavior, making it incorrect for the child’s action in the context of allergic rhinitis symptoms.

Choice C reason: Nasal discharge may occur in allergic rhinitis, but rubbing upward and backward aims to relieve itching and open airways, not prevent discharge. This action is not primarily about controlling runny nose, making this choice less accurate compared to addressing the itching and congestion relief central to the child’s behavior.

Choice D reason: Preventing a sneeze is not the purpose of the "allergic salute." Rubbing the nose upward and backward relieves itching and congestion, common in allergic rhinitis. Sneezing is a separate reflex, and this action does not address it, making this incorrect for the child’s observed behavior in the context of allergy symptoms.