A nurse is providing discharge instructions to a parent and their school-age child who has juvenile idiopathic arthritis.

Which of the following instructions should the nurse include?

Behavioral approaches have the most evidence for treating symptoms of Autism
Spectrum Disorder (ASD)1.
Applied Behavior Analysis (ABA) is a notable behavioral treatment for people with ASD that encourages desired behaviors and discourages undesired behaviors to improve a variety of skills.
A reward system for positive behavior is an example of an ABA technique.
Choice A is not correct because allowing for imaginative play with peers without supervision is not a recommended intervention for a child with ASD.
Choice C is not correct because providing a flexible schedule that adjusts to the child’s interests is not a recommended intervention for a child with ASD.
Choice D is not correct because allowing for adjustment of rules to correlate with the child’s behavior is not a recommended intervention for a child with ASD.

Choice A rationale: Teaching caregivers to change diapers immediately when wet is essential for preventing skin breakdown and secondary infections, especially when an infant has been experiencing high fevers or potential gastrointestinal distress.

Choice B rationale: Administering 16 oz of water to an infant after each stool is dangerous. Infants are at high risk for water intoxication and electrolyte imbalances; rehydration should involve breast milk, formula, or oral rehydration solutions.

Choice C rationale: Cleansing the diaper area with mild soap and water is a standard nursing intervention to maintain skin integrity. It removes irritants and bacteria effectively, reducing the risk of developing a secondary diaper dermatitis.

Choice D rationale: Collecting nasal drainage for culture is not indicated based on the provided vital signs. The infant's temperature has improved, and there is no specific evidence of a worsening respiratory infection requiring a culture.

Choice F rationale: Caregivers should never apply talcum powder to an infant’s skin creases. Talcum powder poses a significant aspiration risk and can lead to severe respiratory distress or chronic lung irritation if inhaled.

Choice G rationale: Using a nasal aspirator should be done before feedings, not after. Suctioning after a feeding can trigger the gag reflex and cause the infant to vomit, increasing the risk of aspiration.