A nurse is planning care for a toddler who has developed oral ulcers in response to chemotherapy. Which of the following actions should the nurse include in the plan of care?

A. Use a 24-gauge catheter to start the IV.A 24-gauge catheter is appropriate for infants due to their smaller veins and the need to minimize trauma. This size allows for adequate fluid and medication administration while reducing the risk of vein damage.

B. Change the IV site every 3 days.IV sites in infants may need to be changed more frequently based on the condition of the site, the type of fluid or medication being administered, and the infant's activity level. The site should be monitored closely for signs of infiltration, phlebitis, or infection, and changed as clinically indicated.

C. Start the IV in the infant's foot.While the foot may be an acceptable site in certain situations, the hands, forearms, or scalp (in younger infants) are often preferred for IV insertion. The foot is less ideal due to the potential for the child to kick or move, increasing the risk of dislodging the IV.

D. Cover the insertion site with an opaque dressing.The insertion site should be covered with a transparent dressing to allow for continuous visualization of the site. This helps in early detection of complications such as infiltration or infection.

Choice A Reason:

Stretch the perineum taut when applying the bag. Taut stretching might cause discomfort or be unnecessary for applying the collection bag and could potentially disrupt the process.

Choice B Reason:

Apply lidocaine gel to the perineum before attaching the bag. Applying lidocaine gel isn't typically necessary for routine urine collection and might not be appropriate for this procedure in an infant without specific indications for its use.

Choice C Reason:

Place a snug-fitting diaper over the drainage bag. Placing a diaper over the collection bag might interfere with the collection process, cause the bag to shift, or create unnecessary pressure on the area.

Choice D Reason:

Position the opening of the bag over the urethra and the anus. Placing the opening of the collection bag over both the urethra and the anus increases the chances of capturing urine effectively. It allows for the collection of a clean catch urine sample while minimizing the risk of contamination from the anus.