A nurse is caring for a child who has Legg-Calve-Perthes disease and is in Buck extension traction.

Which of the following actions should the nurse take?

a.Log rolling is an appropriate technique to reposition a postoperative scoliosis repair patient as it minimizes stress on the spine and helps maintain spinal alignment. Patients need frequent repositioning to prevent pressure ulcers and promote comfort, but every 4 hours may not be frequent enough; typically, every 2 hours is recommended.

b.Protective isolation is not typically required for patients undergoing scoliosis surgery unless they have specific risk factors for infection (e.g., immunocompromised status). Standard postoperative care focuses on monitoring for infection at the surgical site rather than isolation unless indicated by the patient's condition.

c.While it’s important to elevate the head of the bed to assist with breathing and comfort, after scoliosis surgery, the head of the bed is generally elevated to 30-45° to facilitate lung expansion and reduce the risk of aspiration. However, it should be ensured that this angle does not compromise spinal alignment, especially in the early postoperative period.

d.The use of a patient-controlled analgesia (PCA) pump is an appropriate intervention for pain management after scoliosis surgery. It allows the patient to self-administer pain medication within prescribed limits, leading to more effective pain management, improved patient satisfaction, and potentially reduced need for supplemental analgesics.

Choice C, cleanse diaper area with soap and water, is important to maintain hygiene and prevent diaper rash. This should be done at each diaper change.
Choice E, instruct caregivers to apply zinc oxide with each diaper change, is important to prevent diaper rash and promote healing if a rash is present.
Choice D, collect nasal drainage for culture and sensi vity, is important to determine if there is a bacterial infec on present, which could explain theinfant's high fever during the first provider visit.
Choice A, teach caregivers to change diaper when wet, is not necessary as it is already expected that caregivers will change the diaper when wet.
Choice B, have caregivers administer 16 oz of water a er each diarrhea stool, is not necessary as there is no indica on of diarrhea in the scenario.
Choice F, teach caregivers to apply talcum powder to creases, is not necessary as talcum powder has been associated with respiratory problems in infants and should not be used.
Choice G, use a nasal aspirator a er feedings, is not necessary as there is no indica on of nasal conges on in the scenario.