A nurse is providing discharge instructions to the parent of a 10-year-old child following a cardiac catheterization. Which of the following instructions should the nurse include?

Choice A reason: Watching a video game in the playroom is not a good activity for a child who requires airborne precautions, as it may expose the child and other children to the risk of infection. Airborne precautions are used for patients who have diseases that are transmitted by small droplets that can remain suspended in the air and travel over long distances, such as tuberculosis, chickenpox, or measles. The child should stay in a private room with negative air pressure, high-efficiency particulate air (HEPA) filtration, and respiratory protection for health care workers and visitors.

Choice B reason: Putting a large-piece puzzle together is a good activity for a child who requires airborne precautions, as it can be done in the child's room and does not involve close contact with others. It is also developmentally appropriate for a 4-year-old child, as it helps to develop fine motor skills, cognitive skills, and problem-solving skills. The nurse should provide the child with a variety of puzzles that are colorful, fun, and challenging, but not frustrating.

Choice C reason: Constructing a model airplane is not a good activity for a child who requires airborne precautions, as it may involve small pieces that can be easily lost, swallowed, or inhaled. It may also be too difficult or complex for a 4-year-old child, who may not have the attention span, dexterity, or patience to complete the task. The nurse should choose activities that are safe, simple, and suitable for the child's age and abilities.

Choice D reason: Pulling a wagon with toys in the hallway is not a good activity for a child who requires airborne precautions, as it may expose the child and other people to the risk of infection. The child should not leave the room unless it is necessary for diagnostic or therapeutic procedures. If the child has to leave the room, the nurse should ensure that the child wears a mask and follows the infection control guidelines. The nurse should also minimize the movement and transport of the child.

The correct answer is D) A child whose parents answer questions for the child.

Here is a detailed explanation for each choice:

Choice A reason:

A child who has a BMI indicating obesity: While obesity can be a concern for a child’s health, it is not a direct indicator of abuse. Obesity can result from various factors, including genetics, diet, and physical activity levels. It does not necessarily suggest that the child is experiencing abuse or neglect.

Choice B reason:

A child who has frequent visitors: Frequent visitors can indicate a strong support system and concern for the child’s well-being. It is not typically associated with abuse. In fact, children who are abused often have fewer visitors and less social support.

Choice C reason:

A child who uses the call light frequently: Frequent use of the call light may indicate that the child is seeking attention or has unmet needs, but it is not a specific indicator of abuse. Children may use the call light for various reasons, including anxiety, pain, or a need for reassurance.

Choice D reason:

A child whose parents answer questions for the child: This behavior can be a red flag for abuse. When parents consistently answer questions for the child, it may indicate that they are controlling the child’s communication and preventing them from speaking freely. This can be a sign of emotional abuse or manipulation.