The nurse must check vital signs on a 2-year-old boy who is brought to the clinic for his 24-month checkup. Which criteria should the nurse use in determining the appropriate-size blood pressure cuff?

The correct answer is choice A. Wearing cotton underpants.

Choice A rationale:

Wearing cotton underpants is the recommended option to prevent urinary tract infections (UTIs) in young girls. Cotton underpants allow better air circulation, which helps to keep the perineal area dry. This reduces the growth of bacteria and prevents moisture buildup, which are crucial in preventing UTIs. Synthetic fabrics can trap moisture and create a conducive environment for bacterial growth, increasing the risk of UTIs.

Choice B rationale:

Limiting bathing as much as possible is not an appropriate recommendation for preventing UTIs. Hygiene is essential to prevent UTIs, and regular bathing is part of maintaining cleanliness. Overly limiting bathing can lead to poor hygiene practices and may not significantly prevent UTIs, as they are often caused by factors beyond bathing frequency.

Choice C rationale:

Increasing fluids and decreasing salt intake can be beneficial for overall health but may not directly prevent UTIs. While staying hydrated is important for maintaining urinary health, simply increasing fluids and reducing salt intake might not be sufficient to prevent UTIs. Hygiene practices and proper perineal care play a more significant role in preventing UTIs.

Choice D rationale:

Cleansing the perineum with water after voiding is a good hygiene practice, but it alone may not be enough to prevent UTIs. While maintaining cleanliness is crucial, using water to cleanse the perineum after voiding should be combined with other practices, such as wearing cotton underpants and proper wiping techniques, to effectively prevent UTIs.

The correct answer is choice A. The cuff bladder covers 50% to 66% of the length of the upper arm.

Choice A rationale:

Selecting a blood pressure cuff with a bladder that covers 50% to 66% of the length of the upper arm is the appropriate criterion for determining the cuff size for a 2-year-old boy. This range ensures accurate blood pressure measurement by ensuring a proper fit on the arm. If the cuff bladder is too small or too large, it can result in inaccurate readings.

Choice B rationale:

The label "toddler" on the cuff might be helpful in identifying the intended age group, but it doesn't provide precise measurements for cuff sizing. Relying solely on a label might not account for variations in arm sizes within the toddler age group.

Choice C rationale:

The cuff bladder width being 40% of the circumference of the upper arm might not be as accurate as the length-based criterion. A cuff that fits the arm's length is more critical in ensuring proper inflation and accurate blood pressure measurement.

Choice D rationale:

The cuff bladder length covering 80% to 100% of the circumference of the upper arm might result in an excessively large cuff for a 2-year-old, which can lead to inaccurate readings. Length-based sizing is more appropriate for accuracy in this scenario.