A nurse is planning care for a 4-year-old child who requires airborne precautions. Which of the following activities should the nurse plan for the child?

Choice A: An ostomy is a surgical opening in the abdomen that allows stool to pass out of the body. A child who has Hirschsprung disease, which is a condition that causes a blockage of the large intestine due to a lack of nerve cells, may need an ostomy to relieve the obstruction and prevent complications. The ostomy is usually temporary and can be reversed after the affected part of the intestine is removed or repaired. This statement indicates an understanding of the teaching, as the parent knows that the ostomy is not permanent.

Choice B: A urinary catheter is a tube that drains urine from the bladder. A child who has Hirschsprung disease does not need a urinary catheter, as their condition does not affect their urinary system. This statement indicates a lack of understanding of the teaching, as the parent is confused about the type of surgery or device that their child will have.

Choice C: A feeding tube is a tube that delivers nutrition directly into the stomach or small intestine. A child who has Hirschsprung disease may need a feeding tube if they have severe malnutrition, dehydration, or infection due to their condition. However, this is not always necessary and depends on the individual case and the surgeon's preference.
This statement indicates a lack of understanding of the teaching, as the parent assumes that their child will need a feeding tube without knowing the specific plan.

Choice D: A child who has Hirschsprung disease will not have normal bowel movements after the initial surgery, as they will still have an ostomy that bypasses their large intestine. They will need another surgery to reconnect their intestine and restore their bowel function. This statement indicates a lack of understanding of the teaching, as the parent has unrealistic expectations about the outcome of the surgery.

The correct answer is a. Measles, mumps, rubella (MMR) and d. Varicella (VAR).

Choice A reason:

Measles, mumps, rubella (MMR): The MMR vaccine is recommended for children at 12-15 months of age. It protects against three serious diseases: measles, mumps, and rubella. The first dose is typically given at 12-15 months, with a second dose at 4-6 years. Measles can cause severe complications such as pneumonia and encephalitis. Mumps can lead to meningitis and hearing loss, while rubella can cause congenital rubella syndrome in pregnant women. Administering the MMR vaccine at the recommended age ensures that the child is protected from these potentially severe diseases.

Choice B reason:

Rotavirus (RV): This vaccine is given to infants at 2, 4, and possibly 6 months of age. It is not typically administered to a 1-year-old child as the series should be completed by 8 months. Rotavirus is a leading cause of severe diarrhea and dehydration in infants and young children. The vaccine is given orally and is highly effective in preventing rotavirus gastroenteritis. However, since the vaccine series is completed by 8 months, it is not appropriate for a 1-year-old child.

Choice C reason:

Human papillomavirus (HPV4): The HPV vaccine is recommended starting at 11-12 years of age. It is not suitable for a 1-year-old child. HPV is a common virus that can lead to certain types of cancers, including cervical cancer. The vaccine is most effective when given before exposure to HPV, which is why it is recommended for preteens. Administering the HPV vaccine to a 1-year-old would not be appropriate as it is not within the recommended age range.

Choice D reason:

Varicella (VAR): The VAR vaccine is recommended for children at 12-15 months of age to protect against chickenpox. A second dose is given at 4-6 years. Chickenpox can cause an itchy rash, fever, and tiredness. In some cases, it can lead to severe skin infections, pneumonia, and encephalitis. Vaccinating at the recommended age ensures that the child is protected from these complications. The first dose at 12-15 months is crucial for building immunity against the varicella virus.

Choice E reason:

Diphtheria, tetanus and acellular pertussis (DTaP): The DTaP vaccine is given in a series of five doses at 2, 4, 6, 15-18 months, and 4-6 years. The 4th dose is given at 15-18 months, not at 1 year. DTaP protects against three serious diseases: diphtheria, which can cause breathing problems and heart failure; tetanus, which causes painful muscle stiffness; and pertussis (whooping cough), which can lead to severe coughing spells and pneumonia. The timing of the doses is crucial for ensuring effective immunity, and the 1-year mark is not one of the recommended times for the DTaP vaccine.