Which strategy would the nurse apply when vaccinating a child to decrease pain and anxiety?

A. Administering the most painful vaccination first does not reduce pain or anxiety. Evidence-based practice recommends giving the most painful injection last so the child does not associate the entire experience with immediate severe pain. This option may actually increase fear and distress. B. Administering acetaminophen after vaccination is not an effective strategy for reducing procedural pain or anxiety at the time of injection. Additionally, routine prophylactic use of acetaminophen around vaccination is not recommended because it may reduce the immune response to some vaccines. C. Holding the child in a comfort position is the most effective strategy listed. Comfort positioning (such as sitting upright on a caregiver’s lap with gentle restraint) provides emotional security, decreases fear, and has been shown to reduce both pain perception and anxiety during vaccinations. D. Aspirating prior to vaccine administration is not recommended for routine childhood immunizations and does not decrease pain or anxiety. It may actually increase discomfort and prolong the procedure.