A nurse is caring for a client who has a spinal cord injury. Which of the following support devices should the nurse plan to use to prevent plantar flexion contractures?

A. Place a small, folded blanket behind the baby's neck to provide support while in the car seat. Adding extra padding behind the infant’s neck is not recommended, as it can alter the positioning and compromise the safety design of the car seat. Only manufacturer-approved inserts should be used.
B. Anchor the car seat in a rear-facing position in the back seat of the vehicle. Infants under the age of 2 should always be placed in a rear-facing car seat in the back seat. This position offers the best protection for the infant’s head, neck, and spine in the event of a crash.
C. Ensure the water heater temperature is set to no more than 54° C (129.2° F). This temperature is too high and increases the risk of scalding. The recommended maximum temperature for a household water heater is 49° C (120° F) to ensure infant safety.
D. Cover the baby with a cotton blanket when they are asleep. Using loose bedding, including blankets, increases the risk of sudden infant death syndrome (SIDS). Instead, the infant should sleep in a wearable blanket or sleep sack on a firm mattress without soft items.

• Dry skin and lips: This is a very common side effect of isotretinoin due to its drying effects on sebaceous glands. It is expected and manageable with regular moisturizing and is not considered an emergency.
• Increased appetite: Isotretinoin is not associated with increased appetite. Weight changes are not typical or concerning symptoms during therapy and do not warrant urgent provider notification.
• Depression: Isotretinoin has been associated with mood changes including depression, suicidal thoughts, and other psychiatric effects. These can emerge suddenly and must be reported immediately for prompt evaluation and intervention to ensure safety.
• Visual disturbances: Blurred vision or difficulty seeing, particularly at night, can indicate rare but serious complications such as increased intracranial pressure. Any change in vision during isotretinoin therapy requires immediate medical attention.
• Productive cough: This is not commonly linked with isotretinoin therapy. Unless respiratory symptoms worsen or are accompanied by fever or systemic signs, a productive cough alone is not a reason to stop treatment or alert the provider urgently.