A home health nurse is caring for a child who has Lyme disease.

Which of the following is an appropriate action for the nurse to take?

The correct answer is choice D. This test should be performed after your baby is 24 hours old. This is because newborn genetic screening is a set of laboratory tests that detect a set of known genetic diseases that can affect a child’s long-term health or survival. The test is performed on a blood sample obtained from a heel prick when the baby is two or three days old. Performing the test after 24 hours ensures that the baby has had enough time to metabolize certain substances that could interfere with the accuracy of the test.

Choice A is wrong because the blood sample is not drawn from the baby’s inner elbow, but from the heel. Choice B is wrong because the baby does not need to drink water prior to the test, as this could dilute the blood sample and affect the results. Choice C is wrong because the test does not need to be repeated when the baby is 2 months old, unless there is a positive or inconclusive result from the first test.

Newborn genetic screening is important for early detection and intervention of certain conditions that can cause serious health problems or disability if left untreated. Parents should be informed about the benefits and limitations of the test, as well as their rights and options regarding consent and confidentiality.

The correct answer is choice C: “Do you have thoughts of harming yourself?”.

This is the priority question for the nurse to ask the client because it assesses the client’s risk for suicide, which is a serious and potentially life-threatening complication of conduct disorder. The nurse should use a direct and nonjudgmental approach when asking about suicidal ideation and plan.

Choice A: “How do you get along with your peers at school?” is wrong because it is not the most urgent question to ask the client.

While it is important to assess the client’s social relationships and possible peer rejection, this can be done after addressing the client’s safety and mental status.

Choice B: “Do you have a criminal record?” is wrong because it is not relevant to the client’s current condition and might make the client feel defensive or stigmatized.

The nurse should avoid asking questions that imply blame or judgment and focus on the client’s strengths and coping skills.

Choice D: “How do you manage your behavior?” is wrong because it is not appropriate for the nurse to ask the client in an emergency department setting.

This question might imply that the client is responsible for their conduct disorder, which is a complex and multifactorial mental health condition. The nurse should collaborate with the client and their family to develop a behavior management plan that involves positive reinforcement, limit setting, and consistent consequences.

Normal ranges: According to the DSM-5, conduct disorder is characterized by a persistent pattern of behavior that violates the rights of others or societal norms.

The symptoms of conduct disorder include aggression, deceitfulness, destruction of property, serious rule violations, and lack of remorse.

Conduct disorder can cause significant impairment in social, academic, or occupational functioning. The prevalence of conduct disorder is estimated to be 4% among children and adolescents.

The risk factors for conduct disorder include genetic factors, neurobiological factors, environmental factors, and psychological factors.