A nurse is providing discharge teaching to a new parent about breastfeeding her infant. Which of the following statements should the nurse make?

Rationale:

• "We should notify the provider if the cast becomes loose over time.": A loose cast can fail to immobilize the fracture properly, risking displacement or delayed healing. Recognizing this and contacting the provider demonstrates proper understanding of cast care.

• "We should expect the swelling and tingling to worsen before it gets better.": While mild swelling and tingling may occur, increasing or worsening neurovascular symptoms can indicate complications such as compartment syndrome. The parent needs reinforcement that any worsening sensation or cold fingers should prompt immediate provider notification rather than being expected.

• "We need to be very careful about how we handle the cast for the first 2 days while it dries.": Handling a wet cast improperly can deform it and compromise fracture stabilization. Awareness of this indicates correct knowledge of initial cast care.

• "It is important that our child avoids placing anything inside the cast.": Inserting objects into the cast can cause skin irritation, pressure ulcers, or infection. Avoiding this demonstrates understanding of safe cast management.

• "We should prop the casted arm on pillows for the next 24 hours.": Elevation of the casted limb reduces swelling and promotes comfort. This reflects correct knowledge of post-cast care.

Rationale:
A. "The provider can give you a referral for your baby to see an infectious disease provider.": Referring to a specialist does not address the parents’ knowledge or concerns about immunizations. The priority is to engage in a discussion to understand their perspective.

B. "Your baby's immunizations should be up to date before they are able to travel with you by airplane.": Framing immunizations only around travel requirements may seem judgmental and does not address the broader health benefits of vaccination.

C. "You don't have to immunize your baby against diseases that are no longer common.": This statement is misleading because many vaccine-preventable diseases can reemerge if immunization rates drop. It could reinforce misconceptions rather than promoting safe health practices.

D. "Let's talk about what you already know about immunizing your baby.": Beginning with an open-ended, nonjudgmental discussion allows the nurse to assess the parents’ knowledge, beliefs, and concerns. This approach supports informed decision-making and provides an opportunity for accurate, tailored education about vaccines.