hard · NCLEX-RN risk-reduction

The nurse is preparing to insert Toby's peripheral IV line at 15:15. Drag the four nursing steps into the correct chronological sequence to prepare Toby and perform the procedure safely.

1. Step 1: Point to the 'wipe arm' icon on the visual schedule board and gently wipe off the topical anesthetic cream using firm, deliberate pressure.
2. Step 2: Have Toby's parent point to the 'cold clean' and 'IV poke' schedule steps on his tablet to establish cognitive expectation.
3. Step 3: Direct the parent to apply a steady, deep-pressure squeeze to Toby's upper arm and torso immediately before the needle is inserted.
4. Step 4: Perform the needle stick smoothly, secure the line with a protective wrap to prevent pulling, and immediately deliver his preferred reward.
5. Distractor Option: Secure Toby's bilateral wrists using soft pediatric restraint bands to prevent sudden arm pulling during the needle stick.

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