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Difficulty: HardHealth Promotion and Disease Prevention

A practical nurse is collecting data from a 15-month-old toddler during a routine well-child visit. The parents state they have strictly followed a vegan diet for the family. The toddler's current temperature is 99.6°F (37.5°C), and the parents report the toddler has had a mild runny nose for two days without a cough or decreased appetite. The toddler walks independently and points to toys they want to hold. Based on the collected data, which health promotion action by the practical nurse is the most appropriate?

  1. Prepare to administer the scheduled measles, mumps, and rubella (MMR) vaccine as prescribed.Answer
  2. B
    Delay the administration of scheduled live-virus vaccines due to the toddler's current low-grade fever and rhinitis.
  3. C
    Document a concern for developmental delay since the toddler is not yet combining words into simple phrases.
  4. D
    Reinforce teaching about adding whole cow's milk to the toddler's daily intake to promote optimal bone development.

Answer

The most appropriate action is to prepare to administer the scheduled measles, mumps, and rubella (MMR) vaccine.
The correct action is to proceed with the scheduled MMR vaccine. In pediatric health promotion, it is critical to adhere to vaccination schedules. A mild acute illness, such as a runny nose or a low-grade fever (99.6°F / 37.5°C), is not a contraindication to receiving either live or inactivated vaccines. Administering the vaccine at this visit ensures the child remains protected and avoids missed opportunities for disease prevention.

Step-by-Step Solution

1
Evaluate the toddler's developmental milestones based on age.
Walking independently and pointing are appropriate for a 15-month-old. Two-word phrases are not expected until 24 months.
This rules out the need to report or document a developmental delay.
2
Assess the family's dietary practices and preferences.
The family follows a strict vegan diet, meaning all animal products are excluded.
This indicates that recommending cow's milk is culturally and personally inappropriate.
3
Analyze the toddler's current physical symptoms against immunization guidelines.
The toddler has a low-grade temperature (99.6°F / 37.5°C) and mild rhinitis, which constitute a mild acute illness.
According to immunization guidelines, mild acute illness with or without a low-grade fever is not a contraindication to receiving vaccines.
4
Determine the priority health promotion intervention.
The scheduled immunizations, such as the MMR vaccine, should be administered.
Administering the vaccine prevents missed opportunities for essential disease prevention.

Key Concept

Health Promotion and Disease Prevention: Immunization Administration and Contraindications
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Topics

Health Promotion and Disease Prevention

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