The nurse is caring for a 10-month-old infant diagnosed with respiratory syncytial virus (RSV) bronchiolitis. Which interventions should be included in the child's care? (Select all that apply.).

The correct answer is choice A. Slowed growth.

Choice A rationale:

Slowed growth is a potential risk associated with long-term use of inhaled steroids in children with asthma. Inhaled steroids are a cornerstone of asthma management due to their anti-inflammatory effects on the airways, but they can have systemic effects when absorbed in larger amounts. Prolonged use of these steroids can potentially lead to growth suppression in children by affecting the normal growth and development of bones and other tissues.

Choice B rationale:

Osteoporosis is not the primary concern in children taking inhaled steroids. While long-term use of high-dose systemic steroids can lead to bone loss and osteoporosis in adults, the risk of osteoporosis is much lower in children receiving inhaled steroids for asthma management. Inhaled steroids have a lower systemic absorption, reducing the risk of significant bone density reduction in children.

Choice C rationale:

Cushing's syndrome is a condition caused by prolonged exposure to high levels of cortisol, often due to excessive use of systemic steroids. Inhaled steroids, especially at recommended doses, have a lower likelihood of causing Cushing's syndrome compared to systemic steroids. The systemic absorption of inhaled steroids is limited, minimizing the risk of this syndrome.

Choice D rationale:

Cough is not the primary increased risk associated with long-term use of inhaled steroids in children with asthma. Inhaled steroids are actually used to help control and prevent asthma symptoms, including cough. They work by reducing inflammation in the airways, which helps alleviate symptoms like coughing, wheezing, and shortness of breath.

Answer is: d. Apply direct pressure above the catheterization site.

Explanation: The first action should be to apply direct pressure above the catheterization site to help control the bleeding and minimize blood loss. This will also give the nurse time to prepare additional interventions or supplies if necessary.

Choice a. is wrong because placing the child in the Trendelenburg position is not an appropriate initial nursing action in this scenario. This position can increase intracranial pressure and is typically used for patients experiencing shock or hypotension.

Choice b. is wrong because applying a new bandage with more pressure might be a subsequent action, but the priority is to apply direct pressure to slow down the bleeding.

Choice c. is wrong because notifying the physician is important, but the nurse should first take immediate action to control the bleeding and minimize potential harm to the patient.