What is the nurse's first action when planning to teach the parents of an infant with a congenital heart defect (CHD)?

Choice A rationale:
Fever as high as 40° C (104° F). Fever is not typically a common sign or symptom of chronic otitis media with effusion (OME). Chronic OME is characterized by the presence of fluid in the middle ear without signs of acute infection. While fever might occur in acute otitis media, it is not a typical feature of chronic OME.
Choice B rationale:
Severe pain in the ear. Severe pain in the ear is more commonly associated with acute otitis media rather than chronic otitis media with effusion. Chronic OME usually presents with a sensation of fullness or hearing loss in the affected ear due to the accumulation of fluid in the middle ear, but it does not cause severe ear pain.
Choice C rationale:
Nausea and vomiting. Nausea and vomiting are not typical signs or symptoms of chronic otitis media with effusion. These symptoms are more likely to occur in conditions affecting the inner ear or vestibular system, not in chronic OME.
Choice D rationale:
A feeling of fullness in the ear. A feeling of fullness in the ear is a common sign of chronic otitis media with effusion. The accumulation of fluid in the middle ear can cause a sense of fullness or pressure in the affected ear. This sensation might be accompanied by mild hearing loss.

Choice A rationale:
Adjusting the insulin dosage without proper medical guidance can be dangerous for a child with diabetes. Giving half the regular morning dose without considering the child's current blood glucose levels can lead to hypoglycemia, a potentially life-threatening condition. This choice is unsafe and incorrect.
Choice B rationale:
Substituting simple carbohydrates or calorie-containing liquids for solid foods might help maintain the child's blood glucose levels to some extent. However, it's crucial to ensure that the child's overall nutritional needs are met. In cases of illness, monitoring blood glucose levels and consulting with a healthcare provider are essential. This choice, while not the best option, could be a temporary measure if the child is not eating solid foods due to illness.
Choice C rationale:
Giving the child plenty of unsweetened, clear liquids is the most appropriate choice. This helps prevent dehydration, a common concern when a child is not eating or drinking adequately due to illness. Clear liquids, such as water, clear broths, or oral rehydration solutions, can help maintain hydration and provide some electrolytes. It's essential for parents to monitor the child's condition closely and seek medical advice if the child's condition worsens.
Choice D rationale:
Taking the child directly to the emergency department is not necessary if the child is only experiencing a minor illness and is not eating. However, if the child shows signs of severe dehydration, persistent vomiting, or other concerning symptoms, seeking medical attention promptly is crucial. In the absence of these severe symptoms, choice C is the most appropriate course of action.