A 16-year-old has been admitted to the hospital for advanced osteosarcoma with metastasis to the lungs. His prognosis is poor. He is continuing to require oxygen and needs to remain in the hospital for monitoring. The adolescent is very frustrated and states that he doesn't want to stay in the hospital and wants to be with his friends. Which of the following is the best option?

A. Monitoring level of consciousness (LOC): Monitoring the child's level of consciousness is essential as changes in LOC can be an important indicator of the progression of meningitis.

B. Administration of IV antibiotics: Antibiotics are a critical component of the treatment for bacterial meningitis. Early administration of appropriate antibiotics is crucial to control the infection.

C. Decreasing environmental stimuli: Reducing environmental stimuli, such as noise and light, can help minimize discomfort and agitation in a child with meningitis.

D. Increasing IV fluids above maintenance is not typically part of the standard management of bacterial meningitis. Maintaining hydration and electrolyte balance is important, but increasing fluids significantly above maintenance may not be necessary and should be determined based on the child's clinical condition.

E. Instituting droplet precautions: Bacterial meningitis is contagious, and it is important to isolate the child and implement appropriate infection control measures, including droplet precautions, to prevent the spread of the infection to others.

A. Appropriate dose of aspirin and rest: Aspirin is an antiplatelet medication that can worsen bleeding in individuals with hemophilia. It should be avoided. Rest alone is not sufficient in this situation.

B. Immobilization of the leg and a dose of ibuprofen: Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding. Immobilizing the leg may help prevent further injury, but it does not address the underlying bleeding issue or provide the necessary clotting factor.

C. Heating pad and administration of factor VIII concentrate: While the administration of factor VIII concentrate is appropriate, the use of a heating pad is not advisable, as it can potentially worsen bleeding by dilating blood vessels in the area.

D. Pressure on the site and administration of the required clotting factor.

Hemophilia is a bleeding disorder in which the blood doesn't clot properly. When a hemophilic child has a significant bruise or bleeding, it is crucial to administer the specific clotting factor that they are deficient in (Factor VIII or IX) to stop the bleeding. Applying pressure to the site can also help control bleeding.

In summary, option D is the priority because it directly addresses the bleeding issue in the child with hemophilia by applying pressure to the site and administering the necessary clotting factor. This is crucial in preventing further bleeding and complications.