The nurse is counseling first-time parents of a newborn on infant nutrition. The nurse educates parents that infants are physiologically and developmentally ready to begin solids such as rice cereal at what age?

Choice A reason: This is not a good choice. IV fluid bolus of 10 ml/kg is not enough to restore the circulating volume and perfusion in a child with hypovolemic shock. The recommended initial fluid bolus for pediatric hypovolemic shock is 20 ml/kg of isotonic crystalloid solution.

Choice B reason: This is the correct choice. Oxygen, IV fluid bolus of 20 ml/kg, and medications to support cardiac function are the appropriate interventions for a child with hypovolemic shock. Oxygen is given to improve oxygenation and prevent tissue hypoxia. IV fluid bolus of 20 ml/kg is given to replace the lost fluid and blood volume and improve the blood pressure and cardiac output. Medications to support cardiac function may include inotropes, vasopressors, or antiarrhythmics, depending on the child's condition and the cause of the shock.

Choice C reason: This is not a good choice. IV at 2x maintenance is not sufficient to correct the hypovolemia and shock in a child. Maintenance fluids are given to prevent dehydration and electrolyte imbalance, but they are not enough to restore the hemodynamic stability and perfusion in a child with shock. A fluid bolus is needed to rapidly increase the intravascular volume and improve the vital signs.

Choice D reason: This is not a good choice. Oxygen and medication to support cardiac function are important, but they are not enough to reverse the hypovolemic shock in a child. A fluid bolus is the first and most essential intervention to correct the hypovolemia and shock in a child. Giving medication before fluid bolus may worsen the shock and cause adverse effects.

Choice A reason: This statement is correct, as asking about the child's contacts over the last three weeks can help the nurse identify the possible source of infection and the risk of transmission. Rubella is a viral infection that spreads through respiratory droplets or direct contact with an infected person. The incubation period of rubella is 14 to 21 days, meaning that the child could have been exposed to the virus up to three weeks before developing symptoms.

Choice B reason: This statement is incorrect, as asking about the child's immunizations is not the most effective way to determine how the child was exposed to the virus. Although immunization can prevent rubella infection, it is not 100% effective, and some children may still get the disease despite being vaccinated. The nurse should also consider other factors, such as the child's medical history, travel history, and exposure to other people with rash or fever.

Choice C reason: This statement is incorrect, as asking about the medications given to the child is not the most effective way to determine how the child was exposed to the virus. Medications can help relieve the symptoms of rubella, such as fever, rash, or joint pain, but they do not affect the transmission or the course of the infection. The nurse should focus on the epidemiological aspects of the disease, such as the mode of transmission, the incubation period, and the contagious period.

Choice D reason: This statement is incorrect, as asking about the onset of the rash is not the most effective way to determine how the child was exposed to the virus. The rash of rubella usually appears 14 to 17 days after exposure, and lasts for about three days. However, the child can be contagious from seven days before to seven days after the rash appears, meaning that the child could have been exposed to the virus up to four weeks before or after the rash. The nurse should ask about the child's contacts during this period, not just the rash.