An adolescent with a seizure disorder is admitted to the hospital after a fall.The child is increasingly withdrawn and depressed.
Which action should the nurse take to best care for this adolescent?

Choice A rationale

An automated external defibrillator is a device used to treat life-threatening cardiac arrhythmias through defibrillation. While valuable in public spaces, training parents of high-risk infants specifically on AED use is not the primary focus of discharge education. High-risk infants more commonly face respiratory-based arrests rather than shockable cardiac rhythms. Education focuses on immediate manual interventions like CPR, which are more applicable to the common physiological emergencies encountered in the home environment.

Choice B rationale

Pediatric advanced life support is a specialized certification designed for healthcare professionals like doctors, nurses, and paramedics. It involves complex algorithms, the administration of advanced medications, and invasive airway management techniques that are beyond the scope and capability of a layperson or parent. Providing PALS training to parents is inappropriate as they lack the clinical background and equipment necessary to perform these advanced medical interventions safely and effectively.

Choice C rationale

Cardiopulmonary resuscitation training is a vital component of discharge planning for parents of high-risk infants. These infants are at a higher risk for apnea, bradycardia, or sudden respiratory collapse. Teaching parents infant CPR empowers them to provide immediate, life-saving intervention if the infant stops breathing or their heart stops. This manual skill bridges the critical gap between the onset of an emergency and the arrival of professional emergency medical services.

Choice D rationale

First-aid training covers a broad range of minor injuries and illnesses, such as cuts, scrapes, and burns. While useful for general parenting, it does not address the specific, high-stakes physiological risks associated with a high-risk infant transitioning from a neonatal intensive care unit to home. Discharge education must prioritize the most critical life-saving skills, like respiratory support and chest compressions, rather than the general wound care or minor injury management found in first-aid.

Choice A rationale

Intellectual disability involves significant limitations in both intellectual functioning and adaptive behavior. When a child functions within the parameters of a severe neurologic deficit, emotional lability is often a manifestation of the underlying pathology rather than a lack of expected progress. Assessing the child further is always appropriate in clinical practice, but it does not provide the immediate interpretation of why the emotional changes are occurring in relation to the specific disability presented.

Choice B rationale

Temper tantrums are common in pediatric development, but labeling these specific emotional shifts as tantrums that will inevitably lead to self-injurious behavior is a leap in clinical logic. While some children with severe intellectual disabilities may develop self-harming habits as a form of sensory input or communication, it is not a guaranteed progression for every child experiencing anger. Interpreting the behavior as a precursor to self-injury ignores the more likely immediate cause of the emotional distress.

Choice C rationale

Behavioral interventions are certainly a component of a comprehensive care plan for children with neurologic disorders. However, the nurse’s primary role in interpreting these changes is to identify the root cause of the distress before jumping to restrictive or preventative interventions. Focusing solely on preventing harm to others or self misses the opportunity to understand the internal experience of the child, who may be experiencing significant neurological discomfort or environmental overstimulation that triggers the anger.

Choice D rationale

Children with severe intellectual disabilities often lack the cognitive and linguistic skills required to communicate complex internal states, such as pain, hunger, or frustration. Emotional outbursts and anger frequently serve as a substitute for verbal communication when a child is unable to navigate their environment or express specific needs. The nurse must recognize that these behaviors are functional attempts at interaction. Frustration arises when the child’s internal desires are not met by the external support system.