A 3-year-old is immobilized in a hip spica cast. Which discharge instruction should be given to the parents? A. Keep the bed flat, with a small pillow beneath the cast B. Provide crayons and a coloring book for play activity C. Increase her intake of high-calorie foods for healing D. Tuck a disposable diaper beneath the cast at the perineal opening

A hip spica cast is a type of orthopedic cast used to immobilize the hip and thigh area, usually after surgery or hip injury. Its purpose is to help the injured area heal by minimizing the movement of the child.

A. Keeping the bed flat with a small pillow beneath the cast can help maintain the alignment of the cast and provide comfort to the child. This option seems reasonable. B. Providing crayons and a coloring book for play activity helps to keep the child mentally engaged and entertained, but this has nothing to do with the specific care of the hip spica cast. C. Increasing the intake of high-calorie foods for healing might be helpful in some cases, but it is not a specific discharge instruction related to the care of a hip spica cast. D. Tucking a disposable diaper beneath the cast at the perineal opening is a practical way to maintain hygiene and cleanliness for the child while wearing the cast, which is essential to avoid infections and complications.

Among the above options, D. Tuck a disposable diaper beneath the cast at the perineal opening seems to be the most relevant and helpful discharge instruction specific to the care of a hip spica cast. It addresses a major concern related to hygiene, which is important for the proper healing of the casted area.