The nurse provides discharge teaching on mononucleosis. Which statement does the nurse include in the discharge teaching?

Rationale:

A. Patient 1 – 6-year-old with oral lesions from varicella receiving IV fluids: While poor oral intake requires monitoring and IV fluid support, the child’s vital signs and overall status do not indicate immediate life-threatening risk. Assessment is important but not the highest priority.

B. Patient 2 – 14-month-old with meningitis on day 5 of IV antibiotics: This patient is stable mid-course in treatment, showing no acute changes. Ongoing monitoring is necessary, but there are no current signs of decompensation requiring immediate attention.

C. Patient 3 – 6-month-old with hypoplastic left heart syndrome 5 days post-Glenn procedure, O₂ saturation 85%: Low oxygen saturation post-cardiac surgery is a critical finding indicating hypoxemia, which can quickly lead to deterioration. Assessing this patient first is essential to prevent respiratory or cardiac compromise.

D. Patient 4 – 3-year-old with Kawasaki Disease experiencing chest pain and increased pulse: Chest pain and tachycardia are concerning and require prompt evaluation; however, the post-operative cardiac patient with hypoxemia (Patient 3) has an immediate threat to life, making them the highest priority.

Rationale:

A. Somatic problems including frequent stomachaches and headaches: While some children with ASD may have gastrointestinal complaints or somatic symptoms, these are not core manifestations of the disorder. These issues may be secondary to stress, anxiety, or sensory sensitivities rather than defining features.

B. Destructiveness such as intentionally breaking toys, furniture, etc.: Intentional destructiveness is not a typical behavior associated with ASD. Children with ASD may have difficulty with frustration or transitions, but deliberately breaking objects is more characteristic of behavioral disorders rather than autism.

C. Repetitive behavior such as counting, arranging toys in a line, or hand flapping: Repetitive and stereotyped behaviors are hallmark features of ASD. These actions reflect the child’s need for predictability, sensory stimulation, or self-regulation and are commonly observed during early childhood.

D. Impulsive behavior such as throwing toys or running into the street without looking: Impulsivity is not a core symptom of ASD. While children with autism may have challenges with safety awareness or executive functioning, this behavior is more typical of attention-deficit/hyperactivity disorder (ADHD) than ASD.