A preschool-age boy in a daycare facility scratches his head frequently, and the nurse confirms the presence of head lice. The nurse washes the child's hair with permethrin shampoo and calls his parents. Which instruction should the nurse provide to the parents about treatment for head lice?

Choice A reason: Rhabdomyolysis is not the probable cause of the findings. Rhabdomyolysis is a condition that occurs when damaged muscle tissue breaks down and releases substances into the bloodstream that can harm the kidneys. It is usually caused by trauma, infection, drugs, or extreme exercise. It does not cause radial ossification in the soft tissues, but rather dark urine, muscle weakness, and kidney failure.

Choice B reason: Osteosarcoma is the probable cause of the findings. Osteosarcoma is a type of bone cancer that usually affects the long bones of the arms and legs. It is more common in adolescents and young adults. It can cause pain, swelling, and limping in the affected area, as well as radial ossification in the soft tissues, which is a sign of tumor invasion.

Choice C reason: Growing pains are not the probable cause of the findings. Growing pains are a common cause of leg pain in children and adolescents, but they are not associated with any physical abnormality or disease. They usually occur in both legs, not just one, and they are more likely to affect the calves, shins, or thighs, not the knees. They do not cause swelling, tenderness, or radial ossification in the soft tissues.

Choice D reason: Hemosiderosis is not the probable cause of the findings. Hemosiderosis is a condition that occurs when excess iron deposits in the tissues, usually as a result of repeated blood transfusions or hemolytic anemia. It can affect various organs, such as the liver, lungs, heart, and skin, but not the bones. It does not cause pain, swelling, or radial ossification in the soft tissues, but rather fatigue, shortness of breath, chest pain, and skin discoloration.

Choice A reason: Flaring of the nares is a sign of acute respiratory distress in children. It indicates that the child is using the accessory muscles of the nose to breathe, which is a sign of increased work of breathing. Flaring of the nares may be accompanied by other signs of respiratory distress, such as retractions, grunting, or cyanosis. The nurse should report this finding to the health care provider and monitor the child's oxygen saturation, respiratory rate, and level of consciousness.

Choice B reason: Diaphragmatic respirations are not a specific sign of acute respiratory distress in children. They are a normal pattern of breathing in infants and young children, who use their diaphragm more than their chest muscles to breathe. Diaphragmatic respirations may become more pronounced when the child is crying, feeding, or sleeping, but they are not indicative of respiratory distress.

Choice C reason: A resting respiratory rate of 35 breaths/min is not a sign of acute respiratory distress in children. It is within the normal range for a 1-year-old child, who typically has a respiratory rate of 20 to 40 breaths/min. A resting respiratory rate of more than 60 breaths/min may be a sign of respiratory distress in children, especially if it is associated with other symptoms, such as wheezing, coughing, or nasal flaring.

Choice D reason: Bilateral bronchial breath sounds are not a sign of acute respiratory distress in children. They are normal breath sounds that are heard over the trachea and the large bronchi. They are loud and high-pitched, and have a longer expiratory phase than inspiratory phase. Bilateral bronchial breath sounds do not indicate any lung pathology or obstruction.