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

Changes in food selections and preparation can be a minor stressor for hospitalized toddlers, as familiar routines are disrupted. However, while dietary changes might cause some fussiness, they typically do not elicit the profound emotional distress and regression seen with more significant stressors like separation from primary caregivers.

Choice B rationale

Fear of the unknown and painful procedures is certainly a stressor for toddlers. The lack of understanding about medical interventions and the potential for discomfort can cause anxiety. However, for a toddler, the underlying fear of being abandoned by their primary attachment figures often outweighs the fear of the procedures themselves.

Choice C rationale

Unfamiliar people and strange equipment can contribute to a toddler's stress during hospitalization, as they are outside of their usual environment and routine. This can lead to feelings of insecurity and apprehension. However, the emotional impact of these elements is generally less profound than the distress caused by the absence of parents.

Choice D rationale

Separation from parents and home is the most significant stressor for hospitalized toddlers. At this developmental stage, toddlers are deeply reliant on their primary caregivers for security and comfort. Separation can trigger profound feelings of abandonment, anxiety, and lead to regression in developmental milestones.

Choice A rationale

Impulsive and hyperactive behaviors are typically associated with conditions such as attention-deficit/hyperactivity disorder (ADHD), which involves neurodevelopmental differences affecting executive function and impulse control. While these behaviors can sometimes lead to accidents, they are not a direct sign of secondary enuresis.

Choice B rationale

Involuntary passage of feces, known as encopresis, is a distinct elimination disorder characterized by the repeated passage of stool into inappropriate places, often due to chronic constipation and overflow incontinence. It is a separate condition from enuresis, which specifically refers to involuntary urination.

Choice C rationale

Increased thirst, or polydipsia, is a common symptom of conditions like diabetes mellitus or diabetes insipidus, where the body attempts to compensate for fluid imbalances or high glucose levels. While some medical conditions causing enuresis might also involve increased thirst, it is not a direct sign of enuresis itself.

Choice D rationale

Declining invitations for sleepovers is a behavioral manifestation often observed in children with enuresis. The fear of embarrassment and shame associated with involuntary urination during sleep can lead them to avoid situations where their condition might be exposed, such as overnight stays at friends' houses.