A nurse is participating in the care of a 4-year-old child as part of the interdisciplinary team. Which of the following observations should the nurse report to the physical therapist?

A) I’d like to hear your thoughts about giving yourself this medication:
This response encourages open communication and allows the client to express their concerns or fears. It shows empathy and provides an opportunity for the nurse to understand the reasons behind the refusal, which can help tailor the teaching approach. This is an effective way to build trust and involve the client in their care plan.

B) Have you considered how your decision to refuse medication will affect your family?
While this statement highlights the consequences of the client’s actions, it can feel judgmental or guilt-inducing, which may cause the client to become defensive. The nurse should aim to engage the client in a non-judgmental and supportive way rather than focusing on external consequences at this stage.

C) Why don’t you want to learn how to give yourself your medication?
This question could come across as confrontational and may make the client feel pressured or defensive. Instead of focusing directly on the refusal, the nurse should try to understand the client's perspective and barriers, which can be better achieved with a more open and empathetic approach like option A.

D) You will suffer serious health issues if you don’t take your medication:
This response may evoke fear and could be perceived as coercive. It focuses on the negative consequences without first understanding the client’s feelings or reasons for refusing. While the nurse should eventually address the importance of insulin, it’s more effective to first create an open dialogue that respects the client’s autonomy and concerns.

A) Initiate droplet precautions: Respiratory syncytial virus (RSV) is primarily spread through contact with respiratory secretions, and droplet precautions are essential to prevent transmission. While RSV is commonly transmitted via direct contact or droplets, additional precautions like contact precautions may also be required, but droplet precautions should definitely be initiated as part of standard care to prevent the spread of the virus to others.

B) Monitor the preschooler’s urine for protein: Monitoring the urine for protein is not a standard action related to RSV. RSV is a respiratory virus, and its primary symptoms and complications involve the respiratory system, such as difficulty breathing, wheezing, or respiratory distress. There is no direct link between RSV and proteinuria, so this action is not necessary.

C) Administer fluconazole to the preschooler: Fluconazole is an antifungal medication, and it is not used to treat respiratory syncytial virus. RSV is a viral infection, so antiviral medications or supportive care like oxygen therapy, hydration, and possibly bronchodilators may be more appropriate. Fluconazole would not be appropriate for treating a viral infection like RSV.

D) Request an x-ray of the preschooler’s neck: An x-ray of the neck is generally not indicated for RSV unless there is a specific concern about airway obstruction or another condition like croup, which may present with symptoms similar to RSV. RSV primarily affects the lower respiratory tract, leading to symptoms like wheezing, cough, and difficulty breathing, not necessarily requiring a neck x-ray.