The father of a 12-year-old girl reports his daughter does not have high self-esteem. He asks for suggestions to increase her feelings of self-worth. Which activity would be most appropriate for the nurse to suggest?

A. Frequent visitors increase the risk of exposure to infectious agents. Children with immunosuppression should have limited exposure to people with illnesses, and visitors should practice hand hygiene and avoid visiting if sick.

B. Maintaining oral hygiene is crucial because the mouth is a common site for infections, including bacterial and fungal infections. Chemotherapy can cause mucositis, gingivitis, and oral ulcers, which increase the risk of systemic infection. Using a soft-bristled toothbrush and gentle technique reduces trauma while maintaining cleanliness.

C. Children undergoing chemotherapy require adequate protein and calories to support growth, healing, and immune function. Restricting carbohydrates and protein would be detrimental and does not reduce infection risk.

D. Fresh fruits and flowers may harbor bacteria and fungi that can cause infections in immunocompromised children. While mood support is important, safe alternatives include sterile or washed fruits, packaged snacks, or other forms of entertainment.

A. Minimally invasive surgery is not the standard treatment for plagiocephaly. Surgical intervention is typically reserved for rare, severe, or syndromic cases where conservative measures fail or cranial deformities are extreme. Most infants respond well to non-surgical interventions if identified early.
B. Placing an infant on their back is critical for SIDS prevention, but strict supine positioning can contribute to positional plagiocephaly. Therefore, treatment focuses on repositioning the infant during awake periods, encouraging tummy time, and limiting prolonged supine positioning when the infant is awake and supervised, to promote symmetrical skull growth.
C. Helmet therapy, also called cranial orthosis, is considered the most effective intervention for moderate to severe plagiocephaly. The helmet works by gently guiding skull growth as the infant’s skull is still malleable, usually between 4–12 months of age. Infants typically wear the helmet for 23 hours a day, with adjustments made every few weeks by a specialist to ensure proper fit and effectiveness. This therapy is non-invasive, reduces cranial asymmetry, and avoids the need for surgery in most cases. Parents are also instructed on monitoring skin integrity, proper cleaning, and follow-up appointments to track progress.
D. Hospitalization and surgery are unnecessary for standard positional plagiocephaly. Surgical correction is extremely rare and only indicated for congenital cranial malformations or syndromes that do not respond to conservative management.