A nurse is preparing a teaching plan for the parent of a school-age child who has asthma. Which of the following manifestations should the nurse include as an indication of an exacerbation of asthma?

A. The infant does not exhibit fear of strangers.

The infant does not exhibit fear of strangers is not a finding that the nurse should report to the provider, as this is a normal social behavior for a 6-month-old infant. Infants usually develop stranger anxiety between 8 and 12 months of age, when they become more aware of their surroundings and attachment figures.

B. The infant does not roll over from his abdomen to his back.

By 6 months of age, most infants can roll over in both directions— from their abdomen to their back and vice versa. The inability to roll over from abdomen to back may indicate a delay in gross motor skills development. This finding should be reported to the healthcare provider for further evaluation.

C. The infant does not pick up objects from the floor with his fingers.

By 6 months of age, infants typically begin to develop the ability to grasp and pick up objects using their fingers. This milestone is part of fine motor skills development. The inability to pick up objects from the floor with fingers may indicate a delay in fine motor skills and should be reported to the provider for further assessment.

D. The infant does not sit on the floor unsupported.

By 6 months of age, infants typically begin to develop the ability to sit unsupported for short periods. While some variability exists in when infants achieve this milestone, the inability to sit unsupported at 6 months may indicate a delay in gross motor skills development. This finding should be reported to the provider for further evaluation.

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.