A nurse manager is teaching a group of nurses about bacterial meningitis. Which of the following information should the nurse include in the teaching?

A. Apply a cool cloth to the infant's heel 5 min prior to the procedure: Cooling the skin can cause vasoconstriction, making the heel stick more difficult and potentially increasing discomfort. This intervention does not support pain reduction and may prolong the procedure, which can further distress the infant.

B. Promote skin-to-skin contact with the infant's guardian during the procedure: Skin-to-skin contact is an evidence-based method that reduces procedural pain in infants by stabilizing heart rate, enhancing comfort, and lowering stress responses. It offers both analgesic and calming effects, making it an effective strategy during heel sticks.

C. Provide the infant with a bottle of water during the procedure: Water does not provide analgesic benefit to infants and does not activate soothing mechanisms such as the sucrose-induced endorphin release used for pain relief. Offering plain water may also be inappropriate for young infants due to risk of water intoxication.

D. Apply lidocaine/prilocaine cream 15 min prior to the procedure: This topical anesthetic requires significantly longer, typically 30 to 60 minutes, to achieve adequate analgesic effect. Applying it only 15 minutes before the heel stick would not provide sufficient pain control, limiting its effectiveness.

A. "I can change my cat's litter box every day.": Clients with leukemia are immunocompromised and at increased risk for infections such as toxoplasmosis from cat feces. They should avoid changing litter boxes or use protective measures like gloves and masks, so this statement indicates a misunderstanding of infection prevention.

B. "I will avoid blowing my nose when I feel congested.": Avoiding forceful nose blowing helps prevent mucosal trauma and bleeding, which is important for clients with leukemia who may have thrombocytopenia or fragile mucous membranes. This statement demonstrates an understanding of precautions to reduce injury and infection risk.

C. "I can continue gardening in my yard.": Gardening exposes the client to soilborne pathogens and bacteria, increasing the risk of infection. Clients with leukemia should avoid activities that involve soil contact unless using strict protective measures, so this statement indicates a lack of understanding.

D. "I will clean my toothbrush with an alcohol-based mouthwash.": Cleaning a toothbrush with mouthwash is not sufficient to prevent microbial contamination. Clients with leukemia should use a soft-bristled toothbrush and replace it regularly to minimize infection risk. This statement reflects incomplete understanding of oral care precautions.