A nurse is caring for an infant in a provider's office. Medical History Diagnosis: Nurse's Notes Upper respiratory infection Provider prescriptions: Vital Signs • Amoxicillin and clavulanate suspension 225 mg PO twice daily for 10 days Ibuprofen liquid 50 mg PO every 6 to 8 hr, maximum 4 times daily, to treat fever Which of the following actions should the nurse take next to provide appropriate care for the infant?

The correct answer is choice D: Pediculosis capitis.

Choice D rationale: Pediculosis capitis is an infestation of head lice, which causes symptoms such as white flakes that do not brush off the hair easily and a rash on the back of the neck. These symptoms are due to the lice feeding on the scalp and laying eggs (nits), which can cause itching and irritation.

Choice A rationale: Folliculitis is an inflammation of the hair follicles, typically caused by bacterial or fungal infections. While it can cause a rash, it is not characterized by white flakes in the hair.

Choice B rationale: Tinea capitis, also known as ringworm of the scalp, is a fungal infection that causes scaly, itchy patches on the scalp. It may lead to hair loss in the affected areas, but it does not typically cause white flakes that do not brush off the hair.

Choice C rationale: Impetigo contagiosa is a highly contagious bacterial skin infection that causes blisters or sores on the skin. It does not involve white flakes in the hair and primarily affects exposed skin rather than the scalp.

A. Teach caregivers to change diapers when wet.
✅ Correct. Prevents skin breakdown and diaper dermatitis.

B. Have caregivers administer 16 oz of water after each diarrhea stool.
❌ Incorrect. Infants should not get plain water in such amounts. Risk of water intoxication & electrolyte imbalance. Oral rehydration solutions (ORS) or breast milk/formula are recommended instead.

C. Cleanse the diaper area with soap and water.
❌ Incorrect. Harsh soaps can irritate the skin. Best practice: gentle cleansing with warm water or mild wipes, and barrier ointment if needed.

D. Collect nasal drainage for culture and sensitivity.
❌ Incorrect. Only done if ordered and if infection is suspected. At follow-up (Visit #2), infant is afebrile and stable—no need for culture.

F. Teach caregivers to apply talcum powder to creases.
❌ Incorrect. Talcum powder is contraindicated in infants (risk of aspiration & respiratory issues). Barrier creams preferred.

G. Use a nasal aspirator after feedings.
✅ Correct. Safe and effective to clear nasal secretions and prevent aspiration or feeding difficulties.