A nurse is teaching a client about self-administration of sublingual nitroglycerin. Which of the following statements should the nurse include?

• Fever: Fever is a nonspecific but common symptom found in all three conditions—epiglottitis, RSV, and streptococcal pharyngitis. However, it is more severe and abrupt in epiglottitis and low to moderate in RSV and strep throat. In this case, the toddler has had a persistent fever over 38°C, consistent with both RSV and strep.
• Exudate on pharynx: Pharyngeal exudate is a hallmark sign of acute streptococcal pharyngitis, resulting from the inflammatory response to GABHS. It is not typical in RSV or epiglottitis, where erythema and swelling may occur but without purulent exudate.
• Wheezing upon auscultation: Wheezing is a classic sign of RSV, a lower respiratory viral infection leading to bronchiolitis and airway obstruction. It is not a feature of epiglottitis or strep throat, which involve the upper airway and oropharynx, respectively.
• Drooling: Drooling is strongly associated with epiglottitis, due to inflammation and swelling of the epiglottis which makes it painful and difficult to swallow. It is not typical in RSV or strep pharyngitis unless there is severe oral involvement or dehydration.
• Hypoxia: Hypoxia may occur in both epiglottitis and RSV due to airway obstruction or inflammation compromising oxygenation. In epiglottitis, it results from upper airway narrowing; in RSV, from lower airway inflammation and mucus plugging. It is not common in uncomplicated streptococcal pharyngitis.
• Tachypnea: Tachypnea is a sign of respiratory distress and is often present in both epiglottitis and RSV, as the body attempts to compensate for impaired gas exchange. It is not a primary feature of strep pharyngitis unless accompanied by systemic infection or high fever.

A. "Purchase a gift to give to your son from your baby." This is an effective strategy to help a young child feel included and valued, easing the transition and reducing potential jealousy. It fosters a positive emotional connection between the older sibling and the newborn.
B. "Make sure you are holding your baby when your son comes to visit you in the hospital." This may unintentionally make the child feel replaced or left out. It’s better for the parent to be free to hug and reassure the older child during the initial visit.
C. "Use medical terminology when teaching your son about your new baby." Medical terms may confuse or overwhelm a 4-year-old. Simple, age-appropriate language is more effective in helping the child understand the upcoming changes.
D. "Surprise your son with a new bedroom after you bring the baby home." Sudden changes can be disorienting or upsetting for young children. Involving them in the transition process before the baby arrives helps foster a sense of control and comfort.