A nurse is caring for a child who has influenza. The nurse should identify which of the following statements by the parent indicates the child has an increased risk for Reye syndrome.

Choice A: This action is not appropriate, as it may cause more harm than good to separate the child from the parents without sufficient evidence or reason. Separating the child from the parents can cause fear, anxiety, or resentment in both parties and may interfere with establishing rapport and trust. The nurse should only separate the child from the parents if there is an immediate threat or danger to the child's safety.

Choice B: This action is premature, as it may violate confidentiality and ethical principles to report suspected abuse to the authorities without sufficient evidence or reason. Reporting suspected abuse to the authorities can have serious legal and social consequences for both parties and may escalate or worsen the situation. The nurse should only report suspected abuse to the authorities if there is clear evidence or indication of abuse or if mandated by law.

Choice C: This action is irrelevant, as it may not address the issue or help resolve it to ask a psychiatrist to talk with the parents without sufficient evidence or reason. Asking a psychiatrist to talk with the parents can imply that they have mental health problems or that they are guilty of abuse, which can cause stigma, anger, or denial. The nurse should only ask a psychiatrist to talk with the parents if there is evidence or indication of mental health problems or if requested by them.

Choice D: This action is appropriate, as it can help determine whether there is any evidence or reason to suspect abuse or not. Obtaining a detailed history can provide information about how, when, where, and why the bruises occurred and whether they are consistent with accidental or intentional injury. The nurse should obtain a detailed history from both parties separately and in a nonjudgmental and supportive manner.

Choice A: Tachycardia is not a finding that indicates increased intracranial pressure, but rather a sign of shock, dehydration, or pain. Tachycardia is a fast heart rate, which is more than 160 beats per minute in infants. Tachycardia can occur when the body tries to compensate for low blood pressure, fluid loss, or tissue damage.

Choice B: Increased sleeping is a finding that indicates increased intracranial pressure, as it reflects altered level of consciousness, which is one of the earliest and most sensitive signs of increased intracranial pressure. Increased intracranial pressure can compress the brain tissue and affect its function and responsiveness. Increased sleeping can progress to lethargy, stupor, or coma.

Choice C: Brisk pupillary reaction to light is not a finding that indicates increased intracranial pressure, but rather a normal and expected response. A brisk pupillary reaction to light means that the pupils constrict quickly when exposed to bright light and dilate quickly when exposed to dim light. Brisk pupillary reaction to light indicates intact cranial nerve II (optic) and III (oculomotor).

Choice D: Depressed fontanels are not a finding that indicates increased intracranial pressure, but rather a sign of dehydration or malnutrition. Depressed fontanels are sunken or flat areas on the top or back of an infant's head where the skull bones have not yet fused together. Depressed fontanels can occur when there is insufficient fluid or tissue volume in the body.