A nurse is reinforcing teaching about car seat safety with the parents of a 6-month-old infant.
Which of the following statements by the parents indicates a need for further teaching?

Choice A rationale

While the genitourinary system can be affected in individuals with Down syndrome, it is not the most commonly affected body system. Down syndrome is a genetic condition where a person is born with an extra chromosome. This can affect how their brain and body develop, leading to both physical and mental challenges.

Choice B rationale

The reproductive system is not the most commonly affected body system in individuals with Down syndrome. While individuals with Down syndrome can have reproductive health issues, these are not as common as issues with other body systems.

Choice C rationale

The gastrointestinal system can be affected in individuals with Down syndrome, but it is not the most commonly affected body system. Some individuals with Down syndrome may experience gastrointestinal issues such as constipation or gastroesophageal reflux disease.

Choice D rationale

The cardiovascular system is the most commonly affected body system in individuals with Down syndrome. Almost half of babies with Down syndrome have congenital heart disease (CHD), the most common type of congenital anomaly. CHD can lead to high blood pressure in the lungs, an inability of the heart to effectively and efficiently pump blood, and cyanosis (blue-tinted skin caused by reduced oxygen in the blood)3.

Choice A rationale

Applying suction continuously while inserting the suction catheter is not recommended. This could potentially cause trauma to the trachea and lead to complications.

Choice B rationale

Using a large diameter suction catheter for better suctioning is not recommended. The size of the suction catheter should be appropriate for the size of the tracheostomy tube. Using a catheter that is too large could cause trauma to the trachea.

Choice C rationale

Suctioning for no more than 10 seconds at a time is recommended to prevent hypoxia (lack of oxygen). Prolonged suctioning can lead to complications such as hypoxia, trauma to the trachea, and cardiac arrhythmias.

Choice D rationale

Applying suction while the child is exhaling is not recommended. Suction should be applied while withdrawing the suction catheter, not during exhalation.