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Valley fever: This is a common name for coccidioidomycosis, a fungal infection that affects the lungs and is not related to tinea pedis.

Fever blister: This is another name for oral herpes, caused by the herpes simplex virus, and is not related to tinea pedis.

Shingles: This is a viral infection caused by the varicella-zoster virus, the same virus that causes chickenpox, and is not related to tinea pedis.

Induce vomiting with syrup of ipecac: This is not recommended because it can lead to further complications, such as aspiration pneumonia.

Initiate chelation therapy with deferoxamine: This is used to treat iron poisoning, not acetylsalicylic acid overdose.

Administer N-acetylcysteine: This is used as an antidote for acetaminophen (Tylenol) overdose, not for acetylsalicylic acid.

Haemophilus influenza type b (Hib): This vaccine is not contraindicated for individuals with an egg allergy as it does not contain egg protein.

Hepatitis B (HepB): This vaccine is safe for individuals with an egg allergy as it does not contain egg protein.

Inactivated poliovirus (IPV): This vaccine is not contraindicated for individuals with an egg allergy as it does not contain egg protein.

Itching of skin: While this can be a side effect of isotretinoin, it is not as critical as changes in mood. However, any discomfort should still be reported to the healthcare provider.

Back pain: This can be a side effect of isotretinoin, but it is not as critical as changes in mood. However, any discomfort should still be reported to the healthcare provider.

Frequent nosebleeds: This can be a side effect of isotretinoin due to dryness of the nasal passages, but it is not as critical as changes in mood. However, any discomfort should still be reported to the healthcare provider.

Pain when manipulating the affected ear lobe: While this can be a symptom of otitis externa (an infection of the outer ear), it is not typically associated with otitis media, which is an infection of the middle ear.

Erythema and edema of the affected ear: These are more commonly associated with otitis externa or an ear injury, not otitis media.

Clear drainage from the affected ear: This could indicate a ruptured eardrum, which can occur with severe or untreated otitis media, but it is not a typical symptom.

Transport the child to radiology for a throat x-ray: While an x-ray can confirm the diagnosis, it should only be done under the supervision of a healthcare provider due to the risk of airway obstruction.

Obtain a throat culture: This is not typically done in suspected cases of epiglottitis because it could trigger a spasm and cause airway obstruction.

Visualize the epiglottis with a tongue depressor: This should not be done because it can cause airway obstruction and is potentially life-threatening in a child with suspected epiglottitis.

Limit visitors to immediate family members: While limiting visitors can help reduce the risk of infection, it is not specific to the care of an infant with spina bifida undergoing surgical closure of the myelomeningocele sac.

Initiate contact precautions: Unless the infant has a specific infection that requires contact precautions, this is not typically necessary for a child with spina bifida.

Maintain the infant in the supine position: After surgery to close a myelomeningocele, the infant is often positioned prone (on their stomach) to prevent pressure on the surgical site. Therefore, maintaining the infant in the supine position (on their back) is not typically recommended.

“The enzymes probably won’t cause many adverse effects.”: This is correct. Pancreatic enzymes are generally well-tolerated with few side effects.

“I will put the enzyme crystals in his applesauce.”: This is correct. Pancreatic enzymes can be mixed with a small amount of applesauce or other soft foods to make them easier to swallow.

“The enzymes help him digest fat.”: This is correct. Pancreatic enzymes aid in the digestion of fats, proteins, and carbohydrates.

Notify the provider: This might not be necessary at this point unless the child shows other signs of dehydration or illness.

Perform a bladder scan at the bedside: This is typically done if there’s a concern about urinary retention, which doesn’t seem to be the case here.

Provide oral rehydration fluids: This might be considered if the child shows signs of dehydration, but based on the information given, it’s not clear that this is necessary.

Place the infant in an infant seat for 2 hr following the procedure: This is not typically necessary after a lumbar puncture. The infant should be kept flat for several hours after the procedure to reduce the risk of headache and leakage of cerebrospinal fluid.

Keep the infant NPO for 6 hr prior the procedure: This is not typically required for a lumbar puncture. The procedure does not involve the gastrointestinal tract, so there is no need for the infant to be NPO (nothing by mouth).

Hold the infant’s chin to his chest and knees to his abdomen during the procedure: This position is typically used for older children and adults during a lumbar puncture. For infants, the procedure is usually performed with the infant lying on their side, with their back curved and their knees drawn up toward their chest. This position helps to open up the spaces between the vertebrae and make the procedure easier.