The father of a 2-month-old infant calls the advice nurse saying his child has a fever of 38.5°C (101.3°F). The nurse should instruct the father to do which of the following?

Choice A reason: This statement is incorrect, as aspirin is contraindicated in children under 18 years of age due to the risk of Reye syndrome, a rare but serious condition that affects the liver and brain. The nurse should use other methods to reduce the fever, such as acetaminophen, tepid sponge baths, or cooling blankets.

Choice B reason: This statement is incorrect, as hospital-acquired sepsis is unlikely in a 3-day-old infant, unless the infant was exposed to invasive procedures or devices, such as catheters, ventilators, or surgery. The nurse should consider other sources of infection, such as the maternal genital tract, the umbilical cord, or the skin.

Choice C reason: This statement is incorrect, as blood pressure is not an early indicator of sepsis, but a late sign of shock. The nurse should monitor the infant for other signs of sepsis, such as temperature instability, tachycardia, tachypnea, lethargy, poor feeding, irritability, or hypoglycemia.

Choice D reason: This statement is correct, as the most common cause of sepsis in neonates is vertical transmission from the mother during pregnancy, labor, or delivery. The nurse should obtain a history of the mother's prenatal care, infections, medications, or complications, and assess the infant for any congenital anomalies or risk factors.

Choice A reason: Starting bolus feedings to stretch the stomach is not recommended for a child with Nissen fundoplication as it can cause increased pressure on the surgical site and lead to complications such as bleeding, perforation, or slippage of the wrap.

Choice B reason: Venting gastrostomy tube is a correct answer as it allows for the release of gas and fluids from the stomach and prevents gastric distension and discomfort. A gastrostomy tube is often placed during Nissen fundoplication to facilitate feeding and venting.

Choice C reason: Keeping child flat in bed to increase absorption of food is not advised for a child with Nissen fundoplication as it can increase the risk of aspiration and pneumonia. The child should be positioned at a 30-degree angle or higher after feeding to prevent reflux.

Choice D reason: Observing for abdominal distension, flushing and hypotension which may indicate dumping syndrome is a correct answer as it is a potential complication of Nissen fundoplication. Dumping syndrome occurs when food moves too quickly from the stomach to the small intestine, causing symptoms such as abdominal cramps, nausea, diarrhea, sweating, and dizziness.