A nursing student sees the nurse dip a pacifier in a sugar-water solution for an infant before administering an intramuscular injection. The nursing student asks why the nurse provided this sugar-water pacifier. The nurse’s appropriate response is: This will:

Choice A reason: Performing an in/out catheterization is not a suitable method to measure urine output for a 10-month old client with dehydration. An in/out catheterization is a procedure where a catheter is inserted into the bladder through the urethra, and the urine is drained and measured. This method is invasive, painful, and carries the risk of infection and trauma. It is usually reserved for clients who have urinary retention or obstruction, or who need a sterile urine sample.

Choice B reason: Inserting a Foley catheter is also not an appropriate method to measure urine output for a 10-month old client with dehydration. A Foley catheter is a type of catheter that stays in the bladder and drains the urine into a collection bag. This method is also invasive, painful, and carries the risk of infection and trauma. It is usually used for clients who have urinary incontinence, surgery, or long-term bed rest.

Choice C reason: Collecting the client's urine in a cup is not a feasible method to measure urine output for a 10-month old client with dehydration. A cup is not a reliable or accurate device to collect and measure urine, especially for a young child who may not be toilet trained or cooperative. It is also difficult to ensure that all the urine is collected in the cup, and that the cup is not contaminated by other fluids or substances.

Choice D reason: Counting the number of wet diapers is the best method to measure urine output for a 10-month old client with dehydration. This method is non-invasive, simple, and practical. It can provide an estimate of the urine volume and frequency, and indicate the hydration status of the child. The nurse should weigh the diapers before and after use, and record the difference in grams. One gram of weight equals one milliliter of urine. The nurse should also observe the color, odor, and concentration of the urine. The normal urine output for a child is 1 to 2 mL/kg/hour.

Choice A reason: Patient stopped taking the medication 2 days ago is the most important information to report to the health care provider. Prednisone is a corticosteroid medication that suppresses the immune system and reduces inflammation. Prednisone also affects the production of cortisol, a hormone that regulates the stress response, blood pressure, blood sugar, and metabolism. Prednisone should not be stopped abruptly, as this can cause adrenal insufficiency, a condition where the adrenal glands cannot produce enough cortisol. Adrenal insufficiency can cause symptoms such as fatigue, weakness, nausea, vomiting, low blood pressure, and hypoglycemia. The patient should be instructed to resume taking the prednisone and taper the dose gradually under the supervision of the health care provider.

Choice B reason: Patient has not been taking the prescribed vitamin D is not as important as choice A, but still requires further education by the nurse. Vitamin D is a fat-soluble vitamin that helps the body absorb calcium and phosphorus, and maintain bone health. Prednisone can interfere with the metabolism of vitamin D and cause bone loss, osteoporosis, and fractures. The patient should be advised to take the prescribed vitamin D supplement and eat foods rich in vitamin D, such as fatty fish, egg yolks, cheese, and fortified milk.

Choice C reason: Patient has bilateral 2+ pitting ankle edema is not as critical as choice A, but still needs to be monitored by the nurse. Ankle edema is swelling of the ankles due to fluid accumulation in the tissues. Prednisone can cause ankle edema by increasing the sodium and water retention in the body, and reducing the potassium excretion by the kidneys. The patient should be assessed for signs of fluid overload, such as weight gain, shortness of breath, and crackles in the lungs. The patient should also be encouraged to limit the intake of salt and fluids, and elevate the legs when sitting or lying down.

Choice D reason: Patient's blood pressure is 148/94 mm Hg is not as urgent as choice A, but still needs to be addressed by the nurse. Blood pressure is the force of blood against the walls of the arteries. Prednisone can increase the blood pressure by stimulating the renin-angiotensin-aldosterone system, a hormonal system that regulates the blood volume and pressure. The patient should be advised to check the blood pressure regularly, and report any readings above 140/90 mm Hg to the health care provider. The patient should also be counseled to follow a healthy lifestyle, such as exercising, quitting smoking, reducing stress, and eating a balanced diet low in sodium, fat, and cholesterol.