Patient Data

Exhibits

Select the 4 topics the nurse will teach the parents to care for the toddler correctly.

Rationale:

• Parents report infant can choke: Parents’ recognition of choking risk indicates they understood the teaching about feeding precautions and are observing the infant’s cues, which is a desired outcome of education.
• Infant refused bottle after 15 mL: Refusal to finish a bottle indicates ongoing feeding difficulties, suggesting interventions have not fully addressed the infant’s feeding challenges.
• Parents requested nurse feed infant: Reliance on the nurse to feed the infant shows parents are not yet fully confident or comfortable applying the feeding techniques independently, indicating partial effectiveness.
• Respirations 38 breaths/minute: Normalization of respiratory rate post-feeding reflects that the infant is tolerating feeding better and maintaining adequate oxygenation.
• Infant fell asleep after feeding: Falling asleep after such a small intake, especially after crying and refusing the bottle, suggests that the infant is fatigued and exhausted from the effort of feeding. This indicates that the feeding was not successful.
• Infant temperature 98.6° F (37.0° C): Reduction of fever indicates effective management of infection, supporting that interventions like acetaminophen and antibiotics are working.

Rationale:

A. Obtain a booster for all immunizations as soon as possible: While immunizations are important, live vaccines may be contraindicated in children with AIDS depending on their immune status. Boosters should be given only under the guidance of a healthcare provider.

B. Obtain an injection of penicillin G 1000 units weekly: Routine prophylactic penicillin is not indicated for children with AIDS unless there is a specific underlying condition such as sickle cell disease.

C. Keep the child away from other children and begin a home school program: Isolation from peers is unnecessary and can negatively impact social and emotional development. Standard precautions and avoiding exposure to infectious illnesses are more appropriate.

D. Avoid exposure to chickenpox: Children with AIDS are immunocompromised and at high risk for severe complications from varicella infection. Teaching the family to avoid exposure to chickenpox and other infectious diseases is essential to protect the child’s health.