A nurse is caring for a child who was admitted with suspected rheumatic fever. The provider prescribes an antistreptolysin O (ASO) titer. The parent asks the nurse about the purpose of the test. Which of the following responses should the nurse make?

Choice A: Performing range of motion on the infant's hips is not appropriate for an infant who has myelomeningocele, which is a type of spina bifida that causes a sac-like protrusion of the spinal cord and nerves through an opening in the spine. Performing range of motion on the infant's hips can cause nerve damage or pain in the lower extremities, which may already be affected by the condition.

Choice B: Taking an axillary temperature is appropriate for an infant who has myelomeningocele, as it is a non-invasive and accurate method of measuring body temperature. An axillary temperature is taken by placing a thermometer under the armpit and holding the arm close to the body. Taking an axillary temperature can help monitor for signs of infection or inflammation, which are common complications of myelomeningocele.

Choice C: Placing the infant in a side-lying position is not appropriate for an infant who has myelomeningocele, as it can cause pressure or friction on the sac and increase the risk of rupture or infection. The correct position for an infant with myelomeningocele is prone with hips slightly flexed and legs abducted. This position can prevent trauma and promote drainage from the sac.

Choice D: Maintaining a dry dressing over the sac is not appropriate for an infant who has myelomeningocele, as it can cause irritation or infection of the sac and surrounding skin. The correct dressing for an infant with myelomeningocele is moist and sterile with saline or antibiotic solution. This dressing can prevent drying and cracking of the sac and reduce bacterial growth.

Choice A reason: This choice is incorrect because the loss of a parent is not the priority risk factor for suicide completion. Loss of a parent is a stressful life event that may cause grief, depression, or anxiety in an adolescent, but it does not necessarily increase the risk of suicide completion. However, the loss of a parent may be associated with other risk factors such as low self-esteem, poor coping skills, or social isolation, which can contribute to suicidal ideation or behavior.
Choice B reason: This choice is incorrect because a history of substance abuse is not the priority risk factor for suicide completion. History of substance abuse is a behavioral problem that may impair the judgment, mood, or impulse control of an adolescent, but it does not necessarily increase the risk of suicide completion. However, a history of substance abuse may be associated with other risk factors such as mental illness, family conflict, or legal trouble, which can contribute to suicidal ideation or behavior.
Choice C reason: This choice is correct because a previous suicide attempt is the priority risk factor for suicide completion. Previous suicide attempt is a clear indicator of suicidal intent and capability, and it increases the likelihood of future attempts and completion. According to the American Foundation for Suicide Prevention (AFSP), about 40% of people who die by suicide have a history of previous attempts. Therefore, assessing and addressing previous suicide attempts is essential to prevent further harm and save lives.
Choice D reason: This choice is incorrect because active psychiatric disorder is not the priority risk factor for suicide completion. Active psychiatric disorder is a mental health condition that may affect the thoughts, feelings, or behaviors of an adolescent, but it does not necessarily increase the risk of suicide completion. However, active psychiatric disorder may be associated with other risk factors such as hopelessness, helplessness, or isolation, which can contribute to suicidal ideation or behavior.