A nurse is preparing to administer vaccines to a 1-year-old child. Which of the following vaccines should the nurse give? (Select two)

The correct answer is: c. Hold the infant’s chin to his chest and knees to his abdomen during the procedure.

Choice A: Apply a eutectic mixture of lidocaine and prilocaine cream topically 15 min prior to the procedure.

Applying a eutectic mixture of lidocaine and prilocaine (EMLA) cream can help reduce pain during procedures like lumbar punctures. However, it typically needs to be applied 30 to 60 minutes before the procedure to be effective. Applying it only 15 minutes prior would not provide adequate analgesia.

Choice B: Keep the infant NPO for 6 hr prior to the procedure.

Keeping an infant NPO (nothing by mouth) for 6 hours is generally recommended before procedures requiring sedation or anesthesia to reduce the risk of aspiration. However, lumbar punctures do not typically require such prolonged fasting, especially in infants, unless sedation is planned.

Choice C: Hold the infant’s chin to his chest and knees to his abdomen during the procedure.

This is the correct positioning for a lumbar puncture in infants. The infant should be held in a curled-up position, with the chin to the chest and knees to the abdomen, to maximize the space between the vertebrae and allow easier access to the lumbar region. This position helps to stabilize the infant and reduce movement during the procedure.

Choice D: Place the infant in an infant seat for 2 hr following the procedure.

Post-procedure care for a lumbar puncture typically involves monitoring the infant for any signs of complications, such as headache or infection. Placing the infant in an infant seat for 2 hours is not a standard recommendation. Instead, the infant should be observed and allowed to rest comfortably.

Choice A: Muscular dystrophy is not an example of a neural tube defect, but rather a group of genetic disorders that cause progressive weakness and loss of muscle mass. Muscular dystrophy affects the skeletal muscles that control movement and may also affect the heart, lungs, or other organs. Muscular dystrophy is caused by mutations in genes that encode proteins that protect muscle fibers from damage.

Choice B: Spina bifida is an example of a neural tube defect, which is a birth defect that occurs when the neural tube, which is the structure that develops into the brain and spinal cord, does not close completely during the first month of pregnancy. Spina bifida causes an opening in the spine that exposes the spinal cord and nerves and may result in physical and mental disabilities. Spina bifida can be prevented by taking folic acid before and during pregnancy.

Choice C: Hydrocephalus is not an example of a neural tube defect, but rather a condition that causes accumulation of cerebrospinal fluid (CSF) in the brain. Hydrocephalus can increase the pressure inside the skull and damage the brain tissue and function. Hydrocephalus can be caused by congenital defects, infections, injuries, tumors, or bleeding in the brain.

Choice D: Cerebral palsy is not an example of a neural tube defect, but rather a group of disorders that affect movement, balance, and posture. Cerebral palsy is caused by damage to the developing brain before, during, or after birth. Cerebral palsy can affect muscle tone, coordination, reflexes, or speech. Cerebral palsy can be caused by infections, injuries, lack of oxygen, or genetic mutations.