A nurse is teaching the parents of a school-age child who is newly diagnosed with juvenile idiopathic arthritis. Which of the following interventions should the nurse include in the teaching?

A. Obtain a provider order for vaginal/anal culture: A vaginal or anal culture is not indicated at this time because the client’s symptoms—dysuria, urinary frequency, and positive leukocyte esterase—are consistent with a urinary tract infection rather than a sexually transmitted infection or perianal infection.

B. Obtain a provider prescription for antibiotics: The client demonstrates signs of a urinary tract infection, including dysuria, positive leukocyte esterase, elevated WBC count, and cloudy urine. Prompt initiation of antibiotics is important in pregnancy to prevent complications such as pyelonephritis and preterm labor.

C. Obtain a provider prescription for ibuprofen 600 mg every 6 hr for mild to moderate pain: Ibuprofen is generally avoided during the third trimester because it can cause premature closure of the fetal ductus arteriosus and oligohydramnios. Alternative analgesics that are safe in pregnancy should be used instead.

D. Obtain a provider prescription for phenazopyridine: Phenazopyridine is a urinary analgesic that can help relieve dysuria and urinary discomfort while the client awaits antibiotic therapy. It does not treat the infection itself but improves client comfort.

E. Obtain a provider order for a urine culture: A urine culture is indicated to confirm the presence of infection and identify the causative organism. This ensures that antibiotic therapy can be tailored appropriately, which is especially important in pregnancy to reduce maternal and fetal complications.

A. Ritualistic behavior: Ritualistic or repetitive behaviors are characteristic of obsessive-compulsive or obsessive-compulsive personality disorder, not narcissistic personality disorder. These behaviors reflect a need for control rather than grandiosity or self-centeredness.

B. Preoccupied with aging: Clients with narcissistic personality disorder often exhibit preoccupation with self-image, physical appearance, and how aging affects their attractiveness or status. Concerns about aging align with the disorder’s core features of vanity and self-importance.

C. Exhibits separation anxiety: Separation anxiety is typically observed in anxiety disorders, particularly in children, and is not a hallmark feature of narcissistic personality disorder, which centers on self-esteem regulation and interpersonal manipulation.

D. Suspicious of others: Suspiciousness is more characteristic of paranoid personality disorder. While narcissistic clients may be sensitive to criticism, pervasive distrust of others is not a defining trait of narcissistic personality disorder.