A nurse is caring for a 4-year-old child who is 2 days postoperative following the insertion of a ventriculoperitoneal shunt. Which of the following findings should the nurse identify as the priority?

To calculate the appropriate dose of Theophylline for the child weighing 4.69 kg:

Dose = Weight (kg) × Dose (mg/kg)

Dose = 4.69 kg × 4 mg/kg

Dose = 18.76 mg

So, the appropriate dose is approximately 18.7 mg.

A. Give the toddler a hard-tipped sippy cup to drink liquid:

Giving a toddler a hard-tipped sippy cup with a hard spout can increase the risk of injury, especially if the toddler falls while using it. Toddlers at this age are still developing coordination and may not have the motor skills to handle a hard-tipped cup safely. Therefore, this choice would not be appropriate and could potentially harm the toddler.

B. Suction the toddler nose and mouth every hour:

Frequent suctioning of the nose and mouth every hour can cause irritation and discomfort to the toddler. While suctioning may be necessary in certain medical situations, such as clearing mucus or secretions, it should not be done routinely every hour without a specific medical indication. Overuse of suctioning can damage the delicate tissues in the nose and mouth and disrupt the normal mucous membranes.

C. Maintain elbow restraint:

Maintaining elbow restraint is not a standard intervention for a toddler who is 24 hours post-intervention unless there is a specific medical reason for it, such as preventing the toddler from accessing an IV site or medical device. Restraining a toddler's elbows without a clear medical indication can be distressing for the child and may impede their ability to move and explore their environment, which is important for their development.

D. Provide soft foods for the toddler:

Providing soft foods for the toddler is the most appropriate intervention in this scenario. Soft foods are easier for toddlers to chew and swallow, reducing the risk of choking or discomfort, especially if the toddler has undergone certain interventions that may affect their ability to eat solid foods comfortably. Soft foods can include mashed fruits and vegetables, cooked grains, pureed meats, and other easily digestible options suitable for a toddler's age and developmental stage.