A nurse is caring for a child who is 2 hours postoperative following a tonsillectomy. Which of the following fluid items should the nurse offer the child at this time?

Choice A reason: This choice is incorrect because a 1-year-old toddler who has roseola and a temperature of 39° C (102.2° F) is not the most urgent case to assess. Roseola is a viral infection that causes a rash on the trunk and limbs, followed by a high fever that lasts for several days. It usually affects infants and young children and is self-limiting.
The fever can be managed by giving antipyretics such as acetaminophen or ibuprofen, and by providing fluids and comfort measures. The fever does not indicate any serious complication or threat to life.

Choice B reason: This choice is incorrect because a 4-year-old child who has asthma and an O2 sat of 97% is not the most urgent case to assess. Asthma is a chronic respiratory condition that causes inflammation and narrowing of the airways, leading to wheezing, coughing, chest tightness, or shortness of breath. It may be triggered by allergens, irritants, exercise, or infections. The O2 sat is a measure of oxygen saturation in the blood, which indicates how well oxygen is delivered to the tissues. A normal O2 sat range is 95% to 100%, so an O2 sat of 97% indicates that the child has adequate oxygenation and is not in respiratory distress.

Choice C reason: This choice is correct because a 10-year-old child who has sickle cell anemia and reports severe chest pain is the most urgent case to assess. Sickle cell anemia is a genetic disorder that causes the red blood cells to become sickle-shaped and clump together, blocking the blood flow and oxygen delivery to the organs and tissues. It may cause severe pain in the chest, abdomen, joints, or bones, as well as symptoms such as pallor, jaundice, fatigue, or shortness of breath. Severe chest pain may indicate acute chest syndrome, which is a life-threatening complication of sickle cell anemia that involves infection or infarction of the lungs. It may cause fever, cough, hypoxia, or respiratory failure. Therefore, assessing and treating this child is a priority to prevent further damage and death.

Choice D reason: This choice is incorrect because a 7-year-old child who has diabetes insipidus and a urine specific gravity of 1.016 is not the most urgent case to assess. Diabetes insipidus is a rare disorder that affects the balance of fluids in the body. It causes the kidneys to produce large amounts of dilute urine, leading to polyuria, polydipsia, dehydration, or electrolyte imbalance. It may be caused by a deficiency of antidiuretic hormone (ADH) or a resistance to its action. The urine specific gravity is a measure of urine concentration, which indicates how well the kidneys are functioning. A normal urine specific gravity range is 1.005 to 1.030, so a urine specific gravity of 1.016 indicates that the child has normal urine concentration and is not dehydrated.

Choice A: This instruction is not correct, as the child should avoid taking a tub bath for the first 3 days after a cardiac catheterization, which is a procedure that involves inserting a thin tube into a blood vessel and advancing it to the heart to diagnose or treat heart problems. Taking a tub bath can increase the risk of infection or bleeding at the insertion site, which is usually in the groin or arm. The child should take a shower instead and keep the insertion site clean and dry.

Choice B: This instruction is correct, as the child may experience some discomfort or soreness at the insertion site after a cardiac catheterization. Giving the child acetaminophen can help relieve the pain and reduce inflammation. The child should avoid taking aspirin or ibuprofen, as they can increase the risk of bleeding.

Choice C: This instruction is not correct, as the child does not need to stay home for 1 week after a cardiac catheterization unless there are complications or specific instructions from the provider. The child can resume normal activities within 2 to 3 days after the procedure, as long as they avoid strenuous exercise, heavy lifting, or contact sports.

Choice D: This instruction is not correct, as the child does not need to limit their diet to clear liquids for the first 24 hours after a cardiac catheterization unless there are complications or specific instructions from the provider. The child can resume their regular diet as soon as they feel hungry and drink plenty of fluids to flush out the contrast dye used during the procedure.