A nurse is planning care for an 8-month-old infant who has heart failure. Which of the following actions should the nurse include in the plan of care?

Choice AReason:

Exposure to secondhand smoke is incorrect. While exposure to secondhand smoke isn't healthy for anyone, it might not be a primary trigger for seizures in most cases. However, for some individuals, exposure to certain environmental toxins or irritants might exacerbate their condition, though this varies from person to person.

Choice BReason:

Decreased temperature is incorrect. While extreme temperatures (both hot and cold) can potentially trigger seizures in some individuals, decreased temperature alone might not be a common trigger compared to other factors.

Choice C Reason:

Lack of sleep is correct. Sleep deprivation can be a significant trigger for seizures in people with epilepsy or seizure disorders. Maintaining a regular sleep schedule and ensuring adequate sleep is an important aspect of managing seizures in these individuals.

Choice D Reason:

Prolonged headache is incorrect. Headaches can sometimes be a warning sign or an aura before a seizure for some individuals, but having a headache alone might not directly trigger a seizure for most people with a seizure disorder. However, there can be a relationship between headaches and certain types of seizures in specific cases.

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.