A nurse is providing teaching to the guardians of an infant who requires a Pavlik harness.

Which of the following instructions should the nurse include?

A. This is the correct instruction. Varicella (chickenpox) is highly contagious. The child should be kept away from others until all lesions are crusted over and no new lesions have formed for at least 24 hours. This typically indicates that the child is no longer contagious.

B. Applying calamine lotion can help alleviate itching and discomfort associated with the vesicles. This is a supportive measure but does not address the contagious nature of the disease.

C. Dressing the child in warm clothing is not specific to the management of varicella. It is important to keep the child comfortable, but this instruction does not address the
contagious period.

D. It is generally safe to give the child a bath during varicella. Warm baths with mild soap can help soothe itching. However, the child should be dried gently to avoid breaking open any vesicles.

A. Instruct the parent to ensure the pneumococcal vaccine is current.
This is a preventive measure to reduce the risk of infections in individuals with sickle cell disease.

B. Give oral hydroxyurea.
Hydroxyurea is used to decrease the frequency of pain episodes in sickle cell disease.

C. Monitor oxygen saturation continuously.
Continuous monitoring of oxygen saturation is important to detect any potential respiratory complications.

D. Place the client on strict bed rest.
Bed rest helps to reduce the metabolic demands on the body and promotes healing.

E. Restrict oral intake.
During a sickle cell crisis, it's generally not necessary to restrict oral intake unless there are specific indications to do so, such as severe abdominal pain or vomiting that prevents the child from tolerating oral feeds.

F. Apply cold compresses to the affected joints. Administer meperidine IV for pain.
Cold compresses may exacerbate vaso-occlusion, and meperidine is not the first-line choice for pain management in sickle cell crisis due to potential neurotoxicity.
G. Administer meperidine IV for pain.
Meperidine has a relatively short duration of action, which may necessitate frequent dosing. This can lead to more fluctuations in pain control.

H. Administer folic acid as prescribed.
Folic acid supplementation is often recommended for individuals with sickle cell disease to support red blood cell production.