The nurse is caring for a primigravida client who delivered vaginally 48-hours ago.The client's laboratory results are: hemoglobin 12 g/dL (125 g/L), hematocrit 34% (0.34 volume fraction), hepatitis B surface antigen negative, rubella non-immune, group B Streptococcus negative. Which prescription should the nurse prepare to administer?

Choice A rationale

Comparing the temperature of both legs can help identify potential circulatory issues or infections. However, temperature differences are not the most immediate concern when assessing a child with a long-leg cast. Monitoring neurovascular status, including circulation and nerve function, is more critical to ensure there are no complications such as compartment syndrome or impaired blood flow.

Choice B rationale

Monitoring capillary refill of the toes is crucial for assessing the circulatory status of the affected limb. Capillary refill time indicates how well blood is perfusing to the extremities. A delayed capillary refill time can suggest compromised circulation, which could lead to serious complications like tissue ischemia. This assessment helps ensure that the cast is not too tight and that there is adequate blood flow to the toes.

Choice C rationale

Examining for spontaneous movement is important for assessing motor function and ensuring that there is no nerve damage. However, it is not as immediate a concern as circulatory assessment. Spontaneous movement can indicate intact motor function, but circulatory compromise would need to be addressed urgently to prevent tissue damage.

Choice D rationale

Palpating femoral pulses is important for assessing the overall circulation to the lower extremities. However, in the context of a long-leg cast, it is more relevant to directly assess the area distal to the cast (such as the toes) for adequate perfusion. Checking femoral pulses alone does not provide specific information about potential compartment syndrome or tightness of the cast affecting distal circulation.

Choice A rationale

Benzocaine otic drops are used for pain relief and do not address the root cause of infections. Regular use without medical advice can lead to masking of symptoms and possibly delay appropriate treatment. The focus should be on preventing infections through other methods like vaccinations and avoiding irritants.

Choice B rationale

Scheduling a visit for the pneumococcal vaccine is appropriate as it can help protect against Streptococcus pneumoniae, a common cause of otitis media. Vaccinations are a preventive measure to reduce the frequency and severity of infections in infants and children.

Choice C rationale

Giving the infant the full course of antibiotics is crucial in treating and preventing recurrent infections. Incomplete antibiotic courses can lead to bacterial resistance and recurrence of infections. Caregivers must be educated on the importance of adhering to the prescribed treatment plan.

Choice D rationale

Avoiding smoking inside the house is essential as secondhand smoke is a significant risk factor for otitis media. Smoke can irritate the respiratory system and Eustachian tubes, making infants more susceptible to infections. Caregivers should be advised to maintain a smoke-free environment to protect the child's health.