A 3-month-old with myelomeningocele and atonic bladder is catheterized every 4 hours to prevent urinary retention. The home health nurse notes that the child has developed episodes of sneezing, urticaria, watery eyes, and a rash in the diaper area. Which action is most important for the nurse to take?

Rationale: A. Apply zinc oxide to perineum with each diaper change: Zinc oxide can help treat diaper rash and protect skin integrity, but it does not address the systemic allergic reaction symptoms such as sneezing, urticaria, or watery eyes. B. Auscultate the lungs for respiratory pneumonia: Lung assessment is important in children with chronic conditions, but the symptoms described (sneezing, urticaria, watery eyes, and rash) indicate an allergic reaction rather than a respiratory infection. C. Change to latex-free gloves when handling infant: The symptoms are indicative of a latex allergy, which is common in children with myelomeningocele who have frequent catheterizations and medical device exposure. Switching to latex-free gloves is the most important intervention to prevent further allergic reactions and potential anaphylaxis. D. Draw blood to analyze for streptococcal infection: Streptococcal infections typically present with fever, sore throat, or systemic illness. The child’s symptoms are consistent with an allergic reaction rather than infection, so immediate lab testing for strep is not the priority.