The nurse is providing discharge instructions to the caregiver of an infant with recurrent otitis media. Which statement made by the caregiver should the nurse recognize as needing additional education about minimizing subsequent infections?

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: Changing position every 2 hours is not the most important intervention that the nurse should implement. This is because the child's position is limited by the traction and the splint, and frequent repositioning may interfere with the alignment and stability of the fracture. The nurse should only change the position of the child as ordered by the physician and with the assistance of another nurse.

Choice B reason: Assessing skin for redness and signs of tissue breakdown is not the most important intervention that the nurse should implement. This is because the skin is not directly in contact with the traction or the splint, and the risk of pressure ulcers is low. The nurse should still inspect the skin regularly and provide skin care as needed, but this is not the priority.

Choice C reason: Cleansing pin sites as prescribed is not the most important intervention that the nurse should implement. This is because the pin sites are not the main source of infection or complication in this type of traction. The nurse should still follow the protocol for pin site care and monitor for signs of infection, such as redness, swelling, drainage, or odor, but this is not the priority.

Choice D reason: Monitoring peripheral pulses and sensation in the right leg is the most important intervention that the nurse should implement. This is because the traction and the splint can impair the circulation and nerve function of the affected extremity, leading to complications such as compartment syndrome, ischemia, or nerve damage. The nurse should check the pulses, temperature, color, capillary refill, and sensation of the right leg at least every hour and report any changes or abnormalities to the physician.