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: A 13% weight loss is a sign of severe dehydration in an infant, as it indicates a significant loss of body fluids and electrolytes. Dehydration can occur in an infant who has acute gastroenteritis, which is a condition that causes inflammation of the stomach and intestines, leading to vomiting and diarrhea. A 13% weight loss can also cause other signs of dehydration, such as sunken eyes, dry mouth, decreased urine output, and lethargy.

Choice B: A bulging anterior fontanel is not a sign of dehydration in an infant, but rather a sign of increased intracranial pressure, which can be caused by various conditions, such as meningitis, encephalitis, or head trauma. A bulging anterior fontanel can also cause other signs of increased intracranial pressure, such as irritability, headache, vomiting, or seizures.

Choice C: A capillary refill of 3 seconds is not a sign of dehydration in an infant, but rather a sign of normal perfusion and circulation. Capillary refill is the time it takes for the color to return to the nail bed after applying pressure. A normal capillary refill is less than 2 seconds. A prolonged capillary refill of more than 2 seconds can indicate poor perfusion and circulation, which can be caused by various conditions, such as shock, hypothermia, or heart failure.

Choice D: Bradypnea is not a sign of dehydration in an infant, but rather a sign of decreased respiratory rate, which can be caused by various conditions, such as hypoxia, narcotic overdose, or brain injury. Bradypnea can also cause other signs of respiratory distress, such as cyanosis, confusion, or loss of consciousness.

Choice A: Using a pain-rating tool to determine the severity of the joint pain is not the priority assessment for an 8-year-old child who has acute rheumatic fever, which is an inflammatory condition that can affect various organs, especially the heart, joints, skin, and brain. Joint pain is one of the major criteria for diagnosing acute rheumatic fever and can affect one or more large joints, such as knees, ankles, elbows, or wrists. Joint pain can be managed with analgesics or anti-inflammatory drugs.

Choice B: Assessing the client's erythematous rash is not the priority assessment for an 8-year-old child who has acute rheumatic fever, which is an inflammatory condition that can affect various organs, especially the heart, joints, skin, and brain. The erythematous rash is one of the minor criteria for diagnosing acute rheumatic fever and can appear as pink or red patches on the trunk or limbs. The erythematous rash can fade or change location over time and does not require any specific treatment.

Choice C: Identifying the degree of parental anxiety related to the diagnosis is not the priority assessment for an 8-year-old child who has acute rheumatic fever, which is an inflammatory condition that can affect various organs, especially the heart, joints, skin, and brain. Parental anxiety related to the diagnosis can affect their coping skills and ability to care for their child. Parental anxiety can be addressed by providing education, support, and referral to appropriate resources.

Choice D: Auscultating the rate and regularity of the child's heart sounds and notifying the provider immediately of abnormalities is the priority assessment for an 8-year-old child who has acute rheumatic fever, as it can indicate cardiac involvement, which is the most serious complication of acute rheumatic fever. Cardiac involvement can cause damage to the heart valves, myocardium, or pericardium and lead to heart failure or death. Abnormalities in heart sounds may include murmurs, rubs, gallops, or arrhythmias.