A nurse is preparing to administer required immunizations to a toddler during a well-child visit. The parent asks the nurse how many baby aspirins he should administer if the toddler develops a fever.

Which of the following responses should the nurse make?

The nurse should include maintaining elbow restraints on the infant in the plan of care following cleft palate repair. This helps to prevent the infant from touching their surgical site and disrupting the healing process.

a) Allowing the infant to have soft foods may be appropriate, but it is not the highest priority. The infant's diet should be determined by the provider and based on the infant's individual needs.

c) Instructing the parents to feed the infant with a spoon may be appropriate, but it is not the highest priority. The infant's feeding method should be determined by the provider and based on the infant's individual needs.

d) Telling the parents to avoid brushing the infant's teeth for two weeks may be appropriate, but it is not the highest priority. The infant's oral care should be determined by the provider and based on the infant's individual needs.

Answer: A. Apply light pressure to the inner canthus just after instilling the eye drops.

Rationale:

A) Apply light pressure to the inner canthus just after instilling the eye drops.
Applying pressure to the inner canthus (the corner of the eye nearest the nose) helps occlude the nasolacrimal duct. This action reduces the systemic absorption of the medication by preventing it from draining into the nasal passages and subsequently into the systemic circulation, thus enhancing the local effect of the eye drops.

B) Wipe the eye from the inner to the outer canthus with a sterile saline-moistened cotton ball.
While this action may help remove excess medication or discharge, it does not minimize systemic absorption. Instead, wiping the eye could inadvertently spread the medication to other areas, increasing the chance of absorption rather than reducing it.

C) Administer the medication drops directly into the lower conjunctival sac of each eye.
While placing drops in the lower conjunctival sac is a standard practice for delivering ophthalmic medications, it does not directly influence systemic absorption. The main goal is to ensure adequate dosing in the eye, but systemic absorption can still occur if the drops drain into the nasolacrimal duct.

D) Wait 5 min after instillation before instilling the drops in the other eye.
Waiting between instillations is good practice to prevent dilution of the first dose and to allow for absorption. However, this action does not significantly impact systemic absorption. It focuses more on ensuring that the first dose is effective before administering a second dose.