A nurse is caring for a 6-month-old child. The child's provider has ordered a diphtheria, tetanus, and pertussis (DTaP) vaccine to be administered. Which of the following should cause the nurse to question the administration of this vaccine?

A. Hepatitis B (HBV): The Hepatitis B vaccine is typically completed in the infant stage, and a 5-year-old with up-to-date vaccinations would not need a booster for school entry. This is not included in the pre-kindergarten vaccine schedule.

B. Measles, mumps, and rubella (MMR): The MMR vaccine is part of the pre-kindergarten immunization schedule. A second dose is recommended between ages 4 and 6 to ensure immunity before school entry.

C. Haemophilus influenzae type B (Hib): The Hib vaccine is typically administered to infants and young children, and a 5-year-old with up-to-date immunizations would already be fully vaccinated against Hib. No booster is required at this age.

D. Pneumococcal conjugate vaccine (PCV): The PCV vaccine series is usually completed in infancy, and a 5-year-old with current vaccinations would not require a booster. This vaccine is not part of the pre-kindergarten schedule.

A. Wrist: Wrist restraints are typically used to prevent older children or adults from pulling at medical devices or dressings. For an infant, wrist restraints can be too harsh and restrictive. They do not prevent the child from bending their arms, which could allow them to reach their face and potentially disrupt the surgical site.

B. Mummy: A mummy restraint involves wrapping the infant’s body tightly with a blanket to restrict movement, typically used for short periods during medical procedures to keep the child still. This type of restraint is too restrictive for postoperative care and does not allow any movement of the arms, making it uncomfortable and unsuitable for continuous use over extended periods.

C. Elbow: Elbow restraints, also known as no-no’s, are designed to prevent the infant from bending their arms. This type of restraint keeps the elbows straight, preventing the child from touching their face and disrupting the surgical site of the cleft lip and palate. It is effective in allowing the infant to move their arms while ensuring that they cannot interfere with the healing area. This method is less restrictive and more humane for postoperative care in an infant.

D. Jacket: Jacket restraints are used to secure the torso, usually to prevent a child from moving out of bed or a chair. This type of restraint is more restrictive and not specific to preventing arm movement. For an infant recovering from cleft lip and palate surgery, jacket restraints would not effectively prevent the child from reaching their face, and they can be excessively confining and distressing for an infant.