The nurse is administering digoxin as ordered and the child vomits the dose. What action will the nurse take next?

Choice A reason: While some parents may choose to home school their child, this is a personal decision and not a standard recommendation for all children with Trisomy 21. Educational needs should be tailored to the individual child's abilities and preferences, and many children with Trisomy 21 attend public or private schools with appropriate support.

Choice B reason: Teaching the parents about the need for a high-fibre diet is important for overall health but is not specific to Trisomy 21. While children with Trisomy 21 may benefit from a balanced diet, the need for monthly thyroid testing is more directly related to managing their condition.

Choice C reason: Instructing the parents on the need for yearly dental visits is essential for maintaining oral health, but it is not the most critical aspect specific to Trisomy 21. Regular dental check-ups are recommended for all children, regardless of whether they have Trisomy 21.

Choice D reason: Advising the parents that the child will need monthly thyroid testing is crucial because children with Trisomy 21 are at an increased risk for thyroid disorders. Regular monitoring of thyroid function is essential for early detection and management of hypothyroidism or hyperthyroidism, which can significantly impact growth and development.

Choice A reason: Lack of prenatal care is a significant risk factor for neural tube defects, including myelomeningocele, because it often means the mother did not receive important prenatal vitamins like folic acid, which are crucial for proper neural tube development. Prenatal care provides essential screenings and supplements to support a healthy pregnancy and fatal development. Without it, the risk of congenital anomalies, such as myelomeningocele, increases significantly. Additionally, prenatal care helps in identifying and managing other risk factors and conditions that may affect both maternal and fatal health.

Choice B reason: While active Labor with wounds requires medical attention and may pose risks to both mother and baby, it does not directly correlate with an increased risk of myelomeningocele. Myelomeningocele is a congenital condition related to neural tube development early in pregnancy. The presence of wounds in active Labor may indicate complications such as trauma or infection, but these are not associated with neural tube defects.

Choice C reason: Premature rupture of membranes (PROM) is a condition where the amniotic sac ruptures before Labor begins, potentially leading to preterm birth and infections. While PROM is a concern and requires appropriate medical intervention, it is not directly linked to the development of myelomeningocele. The causes of PROM and neural tube defects like myelomeningocele are different, with PROM often related to issues with the amniotic sac or maternal infections.

Choice D reason: Precipitous Labor, which is an unusually rapid Labor and delivery, can pose risks such as trauma to the birth canal and complications for the newborn, but it is not associated with an increased risk of myelomeningocele. The speed of Labor and delivery is not a contributing factor to neural tube defects. Instead, precipitous Labor is more concerning for potential delivery complications and the need for rapid medical response.