An infant with bronchiolitis is taken to the clinic. The infant is congested and febrile with a capillary refill time of 2 seconds.
Which information should the practical nurse (PN) reinforce with the infant's caregiver?

Choice A rationale

Using blunt scissors to do cut-outs typically requires fine motor skills and hand-eye coordination that are characteristic of older preschool-aged children, generally around 3 to 4 years old. A two-year-old is still developing these complex manipulative skills, making this behavior not typical for their developmental stage.

Choice B rationale

Riding a tricycle generally emerges as a developmental milestone for children between 3 to 4 years of age. This activity demands advanced gross motor coordination, balance, and bilateral pedaling skills that are usually beyond the capabilities of an average two-year-old, who is still mastering walking and running.

Choice C rationale

Sustained attention to a picture book for 15 minutes is a cognitive ability that develops with age, typically seen in older preschool or school-aged children. A two-year-old's attention span is much shorter, usually limited to a few minutes, reflecting their ongoing neurological maturation and cognitive development.

Choice D rationale

Taking toys away from another child is a common and normal behavior observed in toddlers. This is characteristic of their egocentric stage of development, where they struggle with sharing and understanding others' perspectives, often leading to possessive actions as they explore their environment and assert their will.

Choice A rationale

Methylergonovine is an ergot alkaloid that directly stimulates sustained uterine contractions. This action is crucial in controlling postpartum hemorrhage by compressing blood vessels within the myometrium, thereby reducing blood loss. The observed excessive bleeding with this delivery necessitates intervention to prevent complications like hypovolemic shock. Its pharmacological effect targets smooth muscle receptors in the uterus.

Choice B rationale

Routine prescription based solely on parity (number of previous pregnancies) is not standard medical practice. Methylergonovine is administered based on clinical indication, primarily to prevent or manage postpartum hemorrhage, which is determined by factors like uterine atony or excessive bleeding, not simply the number of previous births. Unnecessary administration can lead to adverse effects.

Choice C rationale

While methylergonovine does contract the uterus and prevent excess bleeding, this response is a general statement. The best response directly addresses the client's current situation and her question about why *she* is receiving it *this time*. It is crucial to explain the specific clinical reason for her individual prescription, which in this context is likely due to the increased bleeding.

Choice D rationale

This response shifts the responsibility back to the client and does not provide the requested information. It fails to address the client's direct question about the medication's purpose in her specific situation. Providing clear and concise information is essential for client education and adherence to the treatment plan.