A community health nurse is reviewing the levels of disease prevention. Which of the following activities is an example of tertiary prevention?

Choice A reason: Sometimes my child acts bossy with his friends is a common behavior in children as they navigate social interactions and develop leadership skills. While it may require some guidance on social skills, it is not typically a cause for medical concern.

Choice B reason: The teacher says my child has to squint to see the board is concerning because it indicates a potential vision problem. Squinting to see the board can be a sign of refractive errors such as myopia (nearsightedness) or astigmatism. Early detection and correction of vision problems are crucial for a child’s academic performance and overall development.

Choice C reason: My child has recently lost both front top teeth is a normal part of dental development. Children typically lose their primary (baby) teeth around the age of 6 to 7 years as their permanent teeth begin to erupt. This is a natural process and not a cause for concern.

Choice D reason: My child often cheats when we play board games can be a normal part of a child’s development as they learn about rules and fairness. While it may require parental guidance to teach honesty and fair play, it is not typically a medical concern.

Choice A reason: Ask the client to blow his nose

Asking the client to blow his nose is not advisable in this situation. Blowing the nose can increase intracranial pressure and potentially worsen the condition by causing more cerebrospinal fluid (CSF) to leak or even lead to further complications. Therefore, this action should be avoided.

Choice B reason: Suction the nostril

Suctioning the nostril is also not recommended. This action can introduce infection and increase the risk of further complications. It is important to handle any potential CSF leak with care to prevent infection and other issues.

Choice C reason: Notify the physician

While notifying the physician is important, it is not the immediate first step. The nurse should first confirm whether the clear drainage is CSF. Once confirmed, notifying the physician would be the next appropriate step.

Choice D reason: Test the drainage for glucose

Testing the drainage for glucose is the correct first action. CSF contains glucose, so a positive glucose test would confirm that the drainage is indeed CSF. This is a critical step in diagnosing a CSF leak, which can occur with basal skull fractures. Confirming the presence of CSF will guide further medical interventions and management.