A nurse is conducting a group therapy session for several clients. The group is laughing at a joke one of the clients told, when a client who is schizophrenic jumps up and runs out of the room yelling. "You are all making fun of me!" The nurse should identify this behavior as which of the following characteristics of schizophrenia?

A. "I will feed my baby on a schedule every 4 hours": Feeding an infant with heart failure on a strict schedule may not be appropriate because it may not allow the infant to consume adequate calories and nutrients when needed. Infants with heart failure may tire easily during feeding, so they may require more frequent, smaller feedings to ensure adequate intake.

B. "I will add Polycose to each of my baby's bottles": Polycose is a carbohydrate supplement sometimes used to increase the calorie content of infant formula or breast milk. However, adding it to every bottle without guidance from a healthcare provider may not be necessary or appropriate. The decision to use Polycose should be based on the infant's specific nutritional needs and should be directed by the healthcare team.

C. "I will allow my baby to take as much time as needed to finish the bottle": This statement indicates an understanding that infants with heart failure may have difficulty feeding due to fatigue or respiratory distress. Allowing the baby to take as much time as needed to finish the bottle ensures that they can consume an adequate amount of milk without becoming exhausted.

D. "I will limit my baby's crying to 15 minutes prior to each feeding": Limiting the baby's crying before feeding is not directly related to meeting the infant's nutritional needs. While minimizing stress and agitation before feeding can be beneficial, setting a specific time limit on crying may not always be practical or effective.

A. Use a 1.8 mm (0.5 in) needle:

Rationale: Needle length is typically not measured in millimeters for intramuscular injections. The length of the needle for intramuscular injections in preschoolers is usually longer, ranging from 16 to 25 mm (5/8 to 1 inch), depending on factors such as the child's size and the thickness of adipose tissue at the injection site.

B. Use a 20-gauge needle:

Rationale: While the gauge of the needle is important for controlling the flow rate of the medication, the size of the gauge alone does not determine the appropriateness of the needle for administering a vaccine into the deltoid muscle of a preschooler. The gauge of the needle commonly used for intramuscular injections in children is typically between 22 and 25 gauge.

C. Insert the needle at a 15-degree angle:

Rationale: When administering an intramuscular injection into the deltoid muscle, the needle should be inserted at a 90-degree angle (perpendicular to the skin) for children and adults. Using a 15-degree angle would result in a subcutaneous injection rather than reaching the muscle tissue.

D. Insert the needle just below the acromion process:

This is the correct action. When administering a vaccine into the deltoid muscle of a preschooler, the nurse should insert the needle just below the acromion process. This landmark helps ensure accurate placement of the needle into the deltoid muscle, which is the recommended site for intramuscular injections in preschool-age children.