A nurse provides home care instructions to the parents of a child hospitalized with pertussis. The child is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for instructions?

• A. We need to encourage our child to drink fluids
• B. Coughing spells may be triggered by dust or smoke
• C. Vomiting may occur when our child has coughing episodes
• D. We need to maintain droplet precautions and a quiet environment for at least 2 weeks

Answer: (D)

Contagion control and how long a child with pertussis remains contagious is being tested. Pertussis spreads through droplets, and the contagious period changes with treatment. Once an appropriate antibiotic course has begun, the child is typically not contagious after about 5 days of therapy; if untreated, contagiousness can last up to 21 days from the onset of coughing. Saying that droplet precautions and a quiet environment should be kept for at least two weeks implies a longer contagious period than is usually the case with proper treatment, which is why this statement signals a need for instruction. The other statements describe reasonable aspects of care: encouraging fluids to prevent dehydration, recognizing that dust or smoke can trigger coughing spells, and understanding that vomiting can occur during coughing episodes. The nurse would reinforce the correct timeframe for precautions, along with continued hydration, avoidance of irritants, and adherence to the antibiotic plan.