A nurse is planning care for an infant who has congenital talipes equinovarus. Which of the following referrals should the nurse expect the provider to make?

A. Green zone reading on peak expiratory flow meter:

A green zone reading on a peak expiratory flow meter indicates that the child's peak expiratory flow rate (PEFR) is within the normal or stable range. This would not typically be indicative of an exacerbation of asthma. In fact, a green zone reading suggests that asthma is well-controlled.

B. Rhinitis:

Rhinitis, or inflammation of the nasal mucosa, is a common symptom in individuals with asthma, but it is not necessarily indicative of an exacerbation of asthma. Rhinitis can occur due to allergic or non-allergic triggers and may be present even when asthma is well-controlled.

C. Axillary temperature of 37.2°C (99°F):

An axillary temperature of 37.2°C (99°F) is within the normal range for body temperature and is not indicative of an exacerbation of asthma. While fever can occur during exacerbations of asthma, it is not a universal symptom and may be absent in some cases.

D. Hacking, nonproductive cough:

This is the correct option. A hacking, nonproductive cough is a common symptom of asthma exacerbation. During an exacerbation, the airways become inflamed and constricted, leading to coughing. The cough may be dry and unproductive, and it is often worse at night or early in the morning.

A. "Monitor your child for excessive sleepiness."

Methylphenidate is a central nervous system stimulant used to treat attention deficit hyperactivity disorder (ADHD). It typically causes insomnia or decreased need for sleep rather than excessive sleepiness. This option is incorrect, as it does not align with the expected side effects of the medication.

B. "Administer the medication with a caffeinated beverage."

Caffeine is also a stimulant, and combining it with methylphenidate could increase the risk of side effects such as increased heart rate, anxiety, or jitteriness. This instruction is incorrect and unsafe.

C. "Administer the second dose of the medication at lunch time."

Methylphenidate is usually given in divided doses, with the second dose often administered at lunchtime. This timing helps maintain therapeutic levels during the school day while minimizing the risk of insomnia. This option is correct and appropriate for managing the medication.

D. "Monitor your child for weight gain."

A common side effect of methylphenidate is appetite suppression, which can lead to weight loss, not weight gain. This option is incorrect, as the nurse should instruct the parent to monitor for weight loss instead.