What statement by a patient’s mother leads the nurse to determine she understands instructions about administering an oral antibiotic for otitis media?

Choice A reason: Celecoxib, a COX-2 inhibitor, can increase bleeding risk by inhibiting platelet aggregation. Reporting signs of bleeding or bruising is critical, as it may indicate gastrointestinal or systemic bleeding, a known adverse effect. This statement shows appropriate understanding of monitoring for serious side effects.
Choice B reason: Taking celecoxib only as prescribed ensures adherence to the recommended dose and schedule, minimizing risks like gastrointestinal irritation or cardiovascular events. This statement reflects correct understanding of the importance of following medical guidance to optimize safety and efficacy.
Choice C reason: Celecoxib is typically taken once or twice daily, and it can be taken with or without food. Taking it three times daily on an empty stomach is incorrect and may increase gastrointestinal irritation, indicating a need for further education on proper dosing and administration.
Choice D reason: Monitoring urine output is relevant, as celecoxib can cause renal toxicity, leading to decreased urine output or acute kidney injury. This statement shows appropriate awareness of the need to monitor for renal side effects, which is critical for safe use.

Choice A reason: The forward bend test is the standard for scoliosis screening, revealing spinal asymmetry (rib hump) due to lateral curvature. It detects abnormal spinal alignment in preadolescents, when growth spurts exacerbate scoliosis, allowing early intervention to prevent progression.
Choice B reason: Observing gait (heel-to-toe walking) assesses neurological or musculoskeletal function but not spinal curvature. Scoliosis primarily affects spinal alignment, not gait, unless severe, making this less effective for detecting the lateral curvature characteristic of scoliosis.
Choice C reason: Flexing the knees to check knee height assesses leg length discrepancy, not spinal curvature. Scoliosis involves lateral spinal deviation, and knee height is unrelated to detecting the spinal asymmetry critical for diagnosis.
Choice D reason: Observing shoulders and hips while clothed is less effective, as clothing obscures subtle asymmetries. The forward bend test, performed without clothing, better reveals spinal curvature or rib hump, the hallmark signs of scoliosis in preadolescents.