A nurse is caring for an infant who has coarctation of the aorta. Which of the following should the nurse identify as an expected finding?

A) Administer sedation for the procedure: The administration of sedation is typically the responsibility of an anaesthesiologist or a provider. While some procedures may require sedation, the nurse does not initiate this without an order, making this option less appropriate.

B) Schedule an MRI post procedure to verify placement: MRI is not a standard method for verifying the placement of a peripherally inserted central catheter (PICC). Instead, a chest X-ray is usually performed to confirm correct placement in the superior vena cava, making this option inappropriate.

C) Measure the arm circumference above the insertion site daily: This intervention is appropriate as it helps monitor for complications such as swelling or thrombosis. Measuring the circumference can provide important information about the vascular status of the limb and any potential complications related to the catheter.

D) Use gauze to secure an arm board to the involved extremity: While stabilization of the arm may be necessary, gauze is not typically used to secure an arm board. Instead, secure devices or appropriate taping techniques are preferred. This option may not be the most effective or appropriate method for stabilization.

A) Advising the client to limit foods containing vitamin D is not appropriate. Phenytoin can lead to decreased vitamin D levels, making it important to maintain adequate vitamin D intake to support bone health. Therefore, there is no need to restrict these foods.

B) Taking phenytoin with food can help reduce gastrointestinal side effects and improve absorption, making this instruction crucial for the client’s adherence to the medication regimen. It is important for older adults, who may be more sensitive to medications, to have guidance on how to take their medications effectively.

C) Planning to take phenytoin with antacids is not advisable, as antacids can interfere with the absorption of phenytoin. The nurse should instruct the client to space these medications apart to avoid reduced effectiveness of phenytoin.

D) Limiting foods that contain folic acid is unnecessary and not typically advised. In fact, folic acid is important for overall health, and some patients on phenytoin may need additional folic acid supplementation, especially if they have a deficiency. Therefore, this instruction may lead to unintended nutritional deficiencies.