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?

Choice A Reason:

Moisten the mucosa with lemon glycerin swabs. Lemon glycerin swabs might be too acidic and can cause irritation or discomfort in oral ulcers. Using them could exacerbate the toddler's condition.

Choice B Reason:

Cleanse the gums with saline-soaked gauze. This action can help maintain oral hygiene and reduce the risk of infection in the oral ulcers. Saline is gentle and can help keep the affected area clean without causing further irritation.

Choice C Reason:

Administer oral viscous lidocaine. Lidocaine is a local anesthetic that may be used in some cases for pain relief, but its use in oral ulcers for toddlers might not be recommended due to potential risks and concerns about ingestion, especially in young children.

Choice D Reason:

Schedule routine oral care every hour. While oral care is essential, performing it too frequently (every hour) might cause more discomfort and irritation to the already sensitive oral ulcers. Gentle, regular care is important, but excessive cleaning can be detrimental.

Choice A Reason:

Obtain written consent from the client is correct. In many jurisdictions, adolescents have the legal right to consent to STI testing and treatment without parental involvement or notification. Healthcare providers must adhere to confidentiality and privacy laws regarding adolescent health, particularly concerning sensitive issues like STI testing and treatment.

Choice B Reason:

Contact the client's parents to obtain phone consent is incorrect. Contacting the client's parents for consent might breach the adolescent's privacy and confidentiality, particularly in cases where they have the legal right to seek STI testing without parental involvement. In many jurisdictions, adolescents have the right to confidential healthcare services related to sexual health.

Choice C Reason:

Postpone the testing until the client's parents are present is incorrect. Delaying the testing until the client's parents are present could potentially compromise the adolescent's health. Confidentiality and timely access to healthcare services are critical, especially in cases concerning sexual health where prompt testing and treatment might be necessary.

Choice D Reason:

Request verbal consent from the social worker. Obtaining consent through a social worker might not follow proper healthcare protocols. Written consent from the adolescent themselves, if legally permissible, is typically required for such medical procedures, ensuring proper documentation and legal compliance.