An adolescent with a congenital heart defect is admitted for diagnostic testing with surgery scheduled in 3 days. Which intervention should the nurse implement to best support the client's psychosocial needs?

Choice A reason: Instilling benzocaine otic drops regularly is not a recommended practice for preventing or treating otitis media. Benzocaine is a topical anesthetic that can temporarily relieve ear pain, but it does not address the underlying cause of the infection. Moreover, benzocaine can cause allergic reactions, skin irritation, or methemoglobinemia, a condition that reduces the oxygen-carrying capacity of the blood. The nurse should instruct the caregiver to avoid using benzocaine otic drops unless prescribed by a health care provider.

Choice B reason: Avoiding any smoking inside the house is a good practice for preventing otitis media. Smoking can irritate the respiratory tract and impair the function of the cilia, the hair-like structures that help clear mucus and bacteria from the middle ear. Smoking can also increase the risk of respiratory infections, allergies, and asthma, which are associated with otitis media. The nurse should praise the caregiver for avoiding smoking and encourage them to maintain a smoke-free environment for the infant.

Choice C reason: Giving the infant the full course of antibiotics is a necessary practice for treating otitis media. Antibiotics can help eliminate the bacteria that cause the infection and reduce the inflammation and pain in the middle ear. However, antibiotics should be used only when prescribed by a health care provider, and the caregiver should follow the instructions carefully. The nurse should remind the caregiver to give the infant the exact dose of antibiotics at the right time and for the entire duration of the treatment, even if the symptoms improve.

Choice D reason: Scheduling a visit for pneumococcal vaccine is a preventive measure for otitis media. Pneumococcal vaccine can protect the infant from the most common strains of Streptococcus pneumoniae, a bacterium that causes otitis media and other serious infections. The vaccine is recommended for all children under 2 years of age, and it is given in four doses at 2, 4, 6, and 12 to 15 months of age. The nurse should verify the infant's immunization status and advise the caregiver to follow the recommended schedule for the pneumococcal vaccine.

Choice A reason: Asking the boy to describe a typical day at school is the best intervention that the nurse can implement. This can help the nurse identify any possible sources of stress or anxiety that may be causing the boy's physical symptoms. The nurse can also provide emotional support and guidance to the boy and his parents on how to cope with the school-related challenges.

Choice B reason: Conducting a complete neurological assessment is not the best intervention that the nurse can implement. This is not necessary unless the boy has other signs of neurological problems, such as seizures, vision changes, or altered mental status. A neurological assessment may also be invasive and uncomfortable for the boy and may increase his anxiety.

Choice C reason: Counseling the parents to pay more attention to the child is not the best intervention that the nurse can implement. This may imply that the parents are neglectful or irresponsible, which may not be true. The nurse should avoid making assumptions or judgments about the parents' behavior and instead collaborate with them to find the best solutions for the child's well-being.

Choice D reason: Comparing the child's vital signs over the past three weeks is not the best intervention that the nurse can implement. This may not provide much useful information, as the child's vital signs may vary depending on the time of day, activity level, and emotional state. The nurse should focus more on the child's subjective complaints and psychosocial factors.