A nurse is planning care for a child who has osteomyelitis. Which of the following interventions should the nurse include in the plan of care?

Choice A Reason:

Insert an IV catheter for the toddler. While establishing IV access is important for administering medications and fluids, in this scenario, securing the airway takes precedence due to the immediate threat to the child's ability to breathe. Intubation to ensure a clear airway and adequate oxygenation is more critical at this moment.

Choice B Reason:

Prepare the toddler for nasotracheal intubation. These symptoms—hyperpyrexia, severe dyspnea, and drooling—can be indicative of epiglottitis, a potentially life-threatening condition where the airway can become severely compromised due to swelling of the epiglottis. Immediate intervention to secure the airway is crucial in such cases to ensure the child can breathe adequately.

While obtaining an IV catheter, blood culture, and administering antibiotics are important in managing the condition, securing the airway takes precedence in this critical situation to maintain the child's breathing and prevent further respiratory compromise.

Choice C Reason:

Obtain a blood culture from the toddler. Obtaining a blood culture is an essential diagnostic step in identifying potential infections or causes but is not the immediate priority when a child is experiencing severe respiratory distress. Stabilizing the airway and breathing take precedence in this critical situation.

Choice D Reason:

Administer an antibiotic to the toddler. Administering antibiotics might be part of the treatment plan, especially if an infection is suspected, but in an emergent situation where the airway is compromised, securing the airway is the primary concern to ensure the child's ability to breathe and maintain oxygenation.

Choice A Reason:

Allergy to neomycin is correct. Neomycin is an antibiotic, and individuals with a known severe allergic reaction to neomycin should avoid vaccines that contain this component. The MMR vaccine, along with some other vaccines, may contain trace amounts of neomycin, and individuals with a severe allergy to neomycin might be at risk for an allergic reaction if they receive a vaccine containing this substance.

Choice BReason:

Temperature of 37.2° C (99° F) is incorrect. A low-grade fever (slight elevation in temperature) is not a contraindication for the MMR vaccine unless the fever is part of a more severe illness or if the child has a high fever or is significantly unwell.

Choice CReason:

Family history of seizures is incorrect. A family history of seizures generally does not contraindicate the MMR vaccine. However, certain specific medical conditions or individual situations related to seizures might be considered by the healthcare provider.

Choice D Reason:

Upper respiratory infection 2 days ago is incorrect. Having had a mild upper respiratory infection in the recent past, especially if the child has recovered and is feeling well without any fever, is generally not a contraindication for the MMR vaccine. However, if the child is currently acutely ill or has a fever, the vaccine might be postponed until they are feeling better.