A nurse is contributing to the plan of care for a toddler who is receiving intermittent enteral feedings. Which of the following interventions should the nurse include?

A. Understands that death is permanent: Preschoolers generally do not understand the permanence of death. They may view death as temporary or reversible, as their cognitive development is still in the preoperational stage, where they are not fully able to grasp abstract concepts like the permanence of death.
B. Perceives death as a punishment: Preschoolers may view death as a punishment or something they caused, due to their egocentric thinking. They may think that their actions or behaviors (e.g., being "bad") have led to death, as they often see the world from a very self-centered perspective.
C. Has feelings of isolation: Feelings of isolation are more commonly seen in older children or adolescents who understand death better and may have social concerns. Preschoolers are more likely to be confused or fearful about death rather than experiencing isolation.
D. Worries about physical body changes: While preschoolers may be curious about their bodies, their primary focus is usually on the emotional and social aspects of death (e.g., fear of separation from loved ones), rather than worrying about physical body changes associated with dying.

• Steatorrhea: Steatorrhea (fatty stools) is a common symptom of cystic fibrosis due to pancreatic insufficiency. It is not directly related to the current acute infection (Streptococcus pneumonia).
• Barrel chest: A barrel chest is a chronic sign of cystic fibrosis caused by long-standing lung disease and airway obstruction. It is not related to the acute infection (Streptococcus pneumonia) but reflects the long-term effects of cystic fibrosis.
• Hemoptysis 300 mL: Hemoptysis, 300 mL, is a significant and concerning sign of potential worsening condition. While blood-streaked sputum was initially noted, a large volume like 300 mL indicates significant bleeding from the lungs.
• WBC count 17,000/mm³: The initial WBC count was 22,000/mm3, indicating an active bacterial infection. A decrease to 17,000/mm3, while still elevated, suggests that the body's inflammatory response is potentially improving and that the infection IS responding to treatment.
• Oxygen saturation 95% on 1 L oxygen via nasal cannula: The oxygen saturation has improved (from 92% to 95%) with a reduction in the amount of supplemental oxygen, indicating that the patient’s respiratory status is improving.
• Respiratory rate 32/min: The respiratory rate has decreased slightly from 36/min to 32/min, indicating that the patient’s breathing is becoming more stable as the condition improves. However, respiratory rate should still be closely monitored as part of overall progress.