After administering varicella vaccine to a five-year-old child, which instruction should the nurse provide the child's parent?

Apply a cool pack to the injection site to reduce discomfort.

Any level of fever is serious and should be reported right away.

Chewable children's aspirin will help prevent inflammation.

Keep the child home from daycare for the next two days.

Answer and Explanation

The Correct Answer is A

Choice A reason: Applying a cool pack to the injection site is a simple and effective way to reduce discomfort after receiving the varicella vaccine. The cool pack can help numb the pain, decrease swelling, and prevent bruising. The nurse should instruct the parent to apply the cool pack for 10 to 15 minutes at a time, several times a day, as needed.

Choice B reason: Any level of fever is not serious and does not need to be reported right away. Fever is a common side effect of the varicella vaccine and usually lasts for 1 to 2 days. Fever is a sign that the body is developing immunity against the chickenpox virus. The nurse should instruct the parent to monitor the child's temperature and give them acetaminophen or ibuprofen to lower the fever, if necessary. The nurse should also advise the parent to call the health care provider if the fever is higher than 102°F (38.9°C) or lasts longer than 3 days.

Choice C reason: Chewable children's aspirin will not help prevent inflammation and may cause serious harm. Aspirin is not recommended for children under 18 years of age who have viral infections, such as chickenpox, because it can increase the risk of Reye's syndrome, a rare but potentially fatal condition that affects the brain and liver. The nurse should instruct the parent to avoid giving the child aspirin or any products that contain aspirin, such as bismuth subsalicylate.

Choice D reason: Keeping the child home from daycare for the next two days is not necessary and may be inconvenient. The varicella vaccine is very effective at preventing chickenpox and does not pose a risk of spreading the virus to others. The nurse should instruct the parent to resume the child's normal activities, unless they have other symptoms that warrant staying home, such as rash, vomiting, or diarrhea.

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Correct Answer is A

Explanation

Choice A reason: Rice is a gluten-free grain that is safe for people with celiac disease. Rice does not contain the protein gluten that triggers an immune reaction and damages the small intestine in people with celiac disease.

Choice B reason: Oats are generally not recommended for people with celiac disease because they are often contaminated with gluten from other grains during processing. Some people with celiac disease may also react to a protein in oats called avenin that is similar to gluten. Only certified gluten-free oats may be safe for some people with celiac disease, but they should consult their health care provider before consuming them³.

Choice C reason: Barley is a grain that contains gluten and is not safe for people with celiac disease. Barley can cause inflammation and damage to the small intestine in people with celiac disease. Barley is also used to make malt, which is a common additive in many processed foods and beverages.

Choice D reason: Rye is a grain that contains gluten and is not safe for people with celiac disease. Rye can cause the same symptoms and complications as wheat and barley in people with celiac disease. Rye is often used to make bread, crackers, and cereals.

A. Give prescribed intravenous antibiotics. B. Inquire about the client's last meal. C. Contact the healthcare provider. D. Document the client's relief of pain.

Correct Answer is C

Explanation

Choice A reason: Giving prescribed intravenous antibiotics is not the first action that the nurse should take. Antibiotics are used to treat the infection and inflammation caused by appendicitis, but they are not enough to prevent the complications of a ruptured appendix. The nurse should administer the antibiotics as ordered, but only after notifying the healthcare provider of the change in the child's condition.

Choice B reason: Inquiring about the client's last meal is not the first action that the nurse should take. The last meal may be relevant for the preparation of the surgery, but it is not urgent or related to the sudden relief of pain. The nurse should ask about the last meal as part of the preoperative assessment, but only after contacting the healthcare provider.

Choice C reason: Contacting the healthcare provider is the first action that the nurse should take. Sudden relief of pain in a child with appendicitis may indicate a perforation or rupture of the appendix, which is a life-threatening emergency. The nurse should immediately report this finding to the healthcare provider, who may order additional tests or expedite the surgery.

Choice D reason: Documenting the client's relief of pain is not the first action that the nurse should take. Documentation is an important part of nursing care, but it is not a priority in this situation. The nurse should document the child's pain level, vital signs, and interventions, but only after contacting the healthcare provider and taking appropriate actions.

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After administering varicella vaccine to a five-year-old child, which instruction should the nurse provide the child's parent?

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