The nurse is reviewing the client's medical record.

The nurse is assisting with the care the client prior to a blood transfusion

Which of the following actions should the nurse take? Select all that apply.

A) "Our child has a better grasp of reality":
While methylphenidate can improve focus and reduce impulsivity in children with ADHD, a "better grasp of reality" is not a typical or direct effect of the medication. The goal of medication like methylphenidate is to manage symptoms of ADHD, such as inattention, hyperactivity, and impulsivity, rather than altering the child's sense of reality. Therefore, this statement does not reflect an expected outcome of the medication.

B) "Our child has lost some weight since his last appointment":
Weight loss can be a side effect of methylphenidate, as it may reduce appetite. However, this is not an indication that the medication is effective in managing ADHD symptoms. A decrease in weight does not correlate with the desired effects of improved concentration or behavior control. In fact, parents should be educated on monitoring the child’s nutritional intake and discussing any concerns about weight loss with the healthcare provider.


C) "Our child has increased his daily caloric intake":
While it is beneficial for children taking methylphenidate to maintain adequate nutrition, an increase in caloric intake is not directly related to the medication’s effectiveness in treating ADHD. The goal is to improve symptoms of inattention, hyperactivity, and impulsivity, not to focus on changes in food consumption.

D) "Our child is able to complete his homework on time":
This statement is a clear indicator that methylphenidate is working effectively. One of the main goals of treating ADHD is to improve the child's ability to focus and complete tasks, such as homework, within a reasonable time frame. The child being able to complete homework on time reflects the positive effect of the medication in improving concentration, attention, and task completion.

A) Facial erythema:
Facial erythema is commonly seen in children with pertussis due to the intense coughing fits that are characteristic of the disease. The child may experience bursts of violent coughing, which can lead to a flushed appearance, especially in the face, due to increased pressure during coughing. This manifestation is a common and expected sign in children with pertussis.

B) Peeling of the hands and feet:
Peeling of the hands and feet is not a typical manifestation of pertussis. This is more commonly associated with conditions such as toxic shock syndrome or Kawasaki disease. Pertussis primarily presents with respiratory symptoms such as coughing and a characteristic "whooping" sound, not peeling skin.

C) Fever:
While a mild fever may occur in some children with pertussis, it is not the most prominent symptom. Pertussis is more often characterized by severe coughing fits, which can cause vomiting and a distinctive "whooping" sound, particularly during the paroxysmal stage. Fever is typically mild and not the hallmark of the disease.

D) Beefy, red tongue:
A beefy, red tongue is not a typical finding in pertussis. This symptom is more commonly seen in conditions such as scarlet fever or vitamin B12 deficiency. Pertussis primarily presents with respiratory symptoms like severe coughing and difficulty breathing, and does not typically affect the tongue in this manner.