The nurse recognizes that a 4-year-old hospitalized child is exhibiting which characteristic of cognitive development, when the child tells the nurse it’s sad to be at home alone?

Choice A rationale

Post-traumatic stress disorder (PTSD) is a mental health condition that’s triggered by a terrifying event. Symptoms may include flashbacks, nightmares, and severe anxiety. However, a 2-year-old child may not have the cognitive ability to develop PTSD as it requires a certain level of cognitive and psychological development.

Choice B rationale

While separation anxiety is a normal stage of development for infants and toddlers, a 2-year- old child in a burn unit is more likely to be afraid of the pain associated with wound dressing changes rather than being separated from his/her parents.

Choice C rationale

Fear of permanent scarring could be a concern for older children and adults who are more aware of their body image. A 2-year-old child may not have the cognitive ability to understand the concept of permanent scarring.

Choice D rationale

The child is likely worried about the pain associated with the procedure. Pain experienced by patients is likely to increase during procedures such as dressing changes. This is a common and immediate fear for children undergoing medical procedures, especially those associated with pain.

The nurse should include the following information in the teaching about home safety for a 10- month-old infant:

1. Keep plastic bags and plastic grocery bags in a secure place. Plastic bags pose a choking hazard for young children who can easily put them over their heads and suffocate.
2. Serve food in small pieces no larger than a cheerio. This reduces the risk of choking, as infants have limited chewing ability and can easily swallow large pieces of food whole.

E. Use plastic covers on all electrical outlets. This prevents the infant from sticking fingers or objects into the outlet, which could lead to electrical shock.

However, the following information is incorrect and should not be included:

C. Lower the crib rails to the lowest level. While lowering the crib rails might seem convenient, it actually increases the risk of the infant climbing out and potentially falling and injuring themselves. Crib rails should be kept at the highest level possible once the infant can sit up on their own.

D. Set the water heater to 65°C (149°F). This temperature is scalding hot and can cause severe burns in infants. The recommended safe water heater temperature is 120°F (48.9°C) or lower to prevent accidental scalding.

Therefore, the correct selections are A, B, and E. The nurse should emphasize the importance of creating a safe environment for the infant by keeping choking hazards out of reach, serving food in appropriate sizes, and preventing access to electrical outlets. Additionally, the nurse should educate parents about the safe water heater temperature to avoid scalding risks.