What social behavior is most typical of the school-aged child?

Choice A rationale

Monitoring for signs of infection is crucial in children with spina bifida due to the potential for meningitis and urinary tract infections related to neurological deficits and potential openings in the spinal cord. Normal white blood cell count ranges from 4,500 to 11,000 per microliter, and fever, redness, swelling, or purulent drainage would indicate infection.

Choice B rationale

Encouraging mobility is important to promote development and prevent complications like contractures. However, in the immediate postoperative period or with significant neurological impairment, maintaining skin integrity takes precedence to prevent infection and further complications.

Choice C rationale

Providing nutritional support is essential for growth and development in children with spina bifida, who may have feeding difficulties or increased metabolic needs. Adequate nutrition supports overall health, but preventing skin breakdown in areas prone to pressure is a more immediate concern.

Choice D rationale

Maintaining skin integrity is the most important intervention because children with spina bifida often have sensory and motor deficits that make them susceptible to pressure ulcers, especially over bony prominences and the surgical site if a myelomeningocele repair has occurred. Skin breakdown can lead to serious infections and complications.

Choice A rationale

Isotretinoin absorption is enhanced with high-fat meals because it is a lipophilic drug. While this is important for maximizing the medication's effectiveness, it is not the priority nursing action related to the significant risks associated with the drug.

Choice B rationale

Isotretinoin can cause increased photosensitivity, making the skin more susceptible to sunburn. Monitoring for and educating the child and family about sun protection measures, such as sunscreen and protective clothing, is crucial to prevent skin damage.

Choice C rationale

Isotretinoin is a known teratogen, meaning it can cause severe birth defects if taken during pregnancy. Therefore, ensuring that female patients of childbearing potential are using two effective forms of contraception and have a negative pregnancy test before starting treatment is a paramount safety concern and a priority nursing action.

Choice D rationale

There is no specific contraindication or recommendation regarding increased dairy intake for children receiving isotretinoin. Dairy intake does not directly address the major risks associated with the medication.