A nurse is reviewing the medical record of a child who is scheduled to receive a varicella immunization. Which of the following findings in the client's record should the nurse recognize as a contraindication?

A.This statement reflects the client's emotional response to their condition, which is important to address, but it does not indicate a need for immediate medical intervention.

B.Psoriasis is a chronic skin condition characterized by the rapid buildup of skin cells, resulting in thick, red, scaly patches on the skin. Treatment for psoriasis often involves the use of topical medications that are applied to the affected areas. This is a good practice. Old medication should be removed before applying a new dose to ensure the effectiveness of the treatment.

C.This is a reasonable practice as some fabric softeners may contain ingredients that can irritate sensitive skin, including the skin affected by psoriasis. Avoiding fabric softeners or using hypoallergenic alternatives can help reduce potential irritation.

D.Sunlight exposure can actually be beneficial for clients with psoriasis, as ultraviolet (UV) light can help reduce the growth of skin cells and alleviate symptoms. If the client is limiting their sunlight exposure, they might be missing out on a potential therapeutic benefit. However, it is important to balance sun exposure and avoid overexposure to prevent skin damage.

The nurse should take the following actions when receiving a telephone prescription from a client's provider:

1. Ask the provider to spell out the name of the medication: This is important to ensure accurate transcription of the medication name. Spelling out the name helps prevent errors due to similar-sounding medications or confusion with abbreviations.
2. Request that the provider confirm the read-back of the prescription: This step ensures that the nurse and the provider are on the same page and that the prescription has been accurately transcribed. It allows for verification and correction if any discrepancies are identified.
3. Record the date and time of the telephone prescription: Documenting the date and time of the telephone prescription is essential for tracking and reference purposes. It helps establish a clear timeline of events and ensures proper documentation of the medication order.

It is not necessary to withhold the medication until the provider signs the prescription, as telephone prescriptions are typically followed up with a written prescription or electronic verification.

Instructing another nurse to record the prescription in the medical record may not be necessary, as the nurse who received the telephone prescription is responsible for accurately documenting the order in the medical record. However, if necessary, the nurse can delegate the task of documentation to another qualified staff member under their supervision, ensuring accuracy and completeness.