A nurse is creating a plan of care for an adolescent who has muscular dystrophy. Which of the following interventions should the nurse include in the plan?

Choice A reason: Recommending the use of a wheelchair can help prevent stress on the lower extremities, which is important for an adolescent with muscular dystrophy. This condition can lead to muscle weakness and using a wheelchair can aid in mobility and independence.

Choice B reason: Avoiding influenza and pneumococcal vaccines is not recommended. Vaccinations are important for preventing infections, especially in individuals with compromised health conditions like muscular dystrophy.

Choice C reason: Initiating a referral for chest physiotherapy every 4 hours can be beneficial for an adolescent with muscular dystrophy. This therapy can help clear mucus from the lungs and improve respiratory function, which is often compromised in this condition.

Choice D reason: Encouraging the adolescent to perform incentive spirometry is important to maintain lung capacity. Muscular dystrophy can affect the muscles used for breathing, and incentive spirometry can help strengthen these muscles and improve respiratory health.

Choice A reason:

This option addresses electrical safety, which is important for preventing shocks and strangulation hazards in toddlers. However, it does not directly prevent burn injuries from hot water, which is the focus of the question. While hiding wires reduces overall household risks, it does not mitigate scalding hazards. Therefore, this choice is not the correct answer in the context of hot water burn prevention.

Choice B reason:

Turning pot handles toward the back of the stove is a well-known safety measure to prevent toddlers from pulling down hot pots and pans. This reduces the risk of scalds and burns in the kitchen environment. However, the question specifically emphasizes hot water burns, which are more commonly caused by tap water and bathing accidents. Thus, while helpful, this measure does not directly address the hazard highlighted in the scenario.

Choice C reason:

Encouraging outdoor play outside peak sun hours is a measure aimed at reducing sunburn and heat exposure. Sunburn is technically a type of burn, but it is not related to hot water scalds. The question focuses on preventing injuries from household hot water sources, making this option less relevant. While beneficial for overall child safety, it does not answer the specific teaching point.

Choice D reason:

Setting the water heater to 49°C (120°F) is the most effective intervention to prevent scald injuries from hot water in toddlers. Toddlers are at high risk of burns during bathing or when exposed to hot tap water. Lowering the water heater temperature reduces the severity of burns if accidental exposure occurs. This measure directly addresses the hazard in the question, making it the correct answer.