A nurse is administering the Haemophilus influenzae type B vaccine (Hib) to a 6-month-old infant. Which of the following actions should the nurse take?

A. “I will push the medication to the back of my baby's mouth quickly using a syringe":
Pushing medication to the back of the mouth quickly could cause the baby to gag or choke. It’s better to administer the medication slowly to ensure the baby swallows it safely.
B. "I will gently squeeze my baby's cheeks when giving the medication.": Gently squeezing the baby's cheeks helps guide the baby to open their mouth and accept the medication. This ensures safe administration of oral medications without causing discomfort or distress.
C. "I will add the medication to 8 ounces of formula": Adding medication to formula is not recommended as it can alter the medication's effectiveness and make it harder to ensure the correct dosage. It is better to give the medication separately from formula.
D. "I will mix the medication in a 4-ounce bowl of rice cereal at breakfast": Mixing the medication with rice cereal could lead to the baby not receiving the full dose if they do not finish the cereal. Medications should generally be administered separately to ensure the full dose is given.

Rationale for Correct Choice:

• Ceftriaxone: The child has an allergy to cephalosporins, which includes ceftriaxone. Since ceftriaxone is a cephalosporin antibiotic, it would be crucial for the nurse to clarify this prescription to avoid an allergic reaction.
• Medication allergy: The child’s medical history includes an allergy to cephalosporins, and ceftriaxone is a cephalosporin. Administering ceftriaxone to a child with this allergy could lead to an anaphylactic reaction or other serious adverse effects.

Rationale for Incorrect Choices:

• Ondansetron: Ondansetron is an antiemetic used for vomiting, and there is no evidence in the child’s history to suggest that this medication is contraindicated. The prescription for ondansetron does not require clarification based on the child's condition.
• Methylprednisolone: Methylprednisolone is a corticosteroid used to reduce inflammation. While it’s important to monitor the child for potential side effects, there is no indication that this medication would be contraindicated based on the child's condition.
• Budesonide: Budesonide is a corticosteroid inhaler commonly used for asthma or wheezing. There is no indication that this medication should be clarified as it’s appropriate for the child’s symptoms of wheezing and pneumonia.
• Albuterol nebulizer solution: Albuterol is a bronchodilator used to treat wheezing and bronchospasm. There is no indication that this medication needs clarification, as it is appropriate for the child’s respiratory symptoms.
• Vital signs: While the child’s vital signs show an elevated heart rate and respiratory rate, they do not provide a reason to clarify a medication prescription. These vital signs are likely a result of the infection and fever rather than an issue that affects medication choices.
• WBC count: The WBC count is mildly elevated, which is consistent with infection, but there is no reason to question medication orders based solely on this result. It does not affect the choice of antibiotics or other prescribed treatments.
• Scheduled chest x-ray: The scheduled chest x-ray is a part of the diagnostic process and does not impact the prescription of medications. It does not need to be clarified with respect to the medications ordered.
• Sodium level: The sodium level is within the normal range, so there is no need to clarify medication prescriptions based on this finding. It does not influence medication choices directly.