A nurse is reviewing the medical record of a client who is taking acetaminophen to relieve headache pain.

Which of the following conditions in the client's history should the nurse identify as a contraindication?

Correct answer:

A. Have the child take a tub bath each morning: Warm tub baths are recommended for children with juvenile idiopathic arthritis (JIA) as they help to relieve joint stiffness and pain, especially in the morning. The warm water can soothe the joints, making movement easier and reducing discomfort throughout the day.

Why the other options are less appropriate:

B. Apply splints to the child's extremities during the day: While splints may be used in JIA, they are typically applied during the night (resting splints) to maintain joint position and prevent contractures. Daytime use of splints (working splints) may be considered in certain situations, but generally, children are encouraged to be as active as possible during the day to maintain joint mobility.

C. Encourage the child to take naps during the day: While rest is important, encouraging too much rest during the day may contribute to joint stiffness. Regular activity helps maintain joint function and mobility, which is essential in managing JIA.Frequent daytime naps also interfere with the child's quality of sleep.

D. Keep the child on bedrest as long as pain persists: Prolonged bedrest is not recommended for children with JIA. It can lead to muscle atrophy, increased stiffness, and reduced joint mobility. Instead, the focus should be on maintaining activity within the child's pain tolerance and using pain management strategies.

The correct answer is C.

Engage in low-impact aerobic exercises. Low-impact aerobic exercises, such as walking, swimming, or cycling, can help improve joint mobility, muscle strength, and cardiovascular health in clients with arthritis. They can also reduce pain and inflammation by increasing blood flow and oxygen delivery to the joints. The nurse should advise the client to avoid high-impact exercises, such as running or jumping, that can worsen joint damage and pain. The nurse should also recommend sleeping on a firm mattress that supports the spine and joints, applying heat to relax stiff muscles and joints, and using assistive devices or palms to push off from surfaces to avoid putting extra stress on the fingers.