A nurse is caring for a preschooler who has heart failure and a new prescription for furosemide 4 mg/kg every 8 hr. The child weighs 16 kg (35 lb). Available is furosemide oral solution 40 mg/5 mL. How many mL should the nurse administer with each dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Rationale for Correct Choices:

• Check the child's oropharynx: The child has had a tonsillectomy and is showing signs of possible bleeding, indicated by the small amount of bleeding in the posterior pharynx and bright red emesis (vomiting of blood). The nurse should check the oropharynx to assess the amount and source of the bleeding, as this could indicate a complication post-surgery.
• Obtaining a set of vital signs: After vomiting bright red emesis, it is crucial to assess the child's vital signs to monitor for signs of bleeding or shock. Changes in vital signs, especially increased heart rate or decreased blood pressure, could indicate significant blood loss.

Rationale for Incorrect Choices:

• Offer the child a red popsicle: Red-colored foods are generally avoided post-tonsillectomy as they can obscure or be mistaken for blood. More importantly, offering anything by mouth is contraindicated during active bleeding due to the risk of aspiration and potentially dislodging clots.
• Place the child in a supine position: The child should be positioned in a way that allows for the drainage of blood and secretions, ideally with the head elevated. Placing the child in a supine position could cause blood to pool in the throat, increasing the risk of aspiration.
• Encouraging the child to cough and deep breathe: Encouraging coughing and deep breathing immediately after tonsillectomy is not recommended, as it could dislodge a clot or exacerbate bleeding.
• Requesting a prescription for codeine: Although the child is experiencing some pain (rated 3/10), the primary concern at this point is bleeding, not pain. Pain management should be adjusted but the focus should be on addressing the bleeding first.

A. Buck extension: Buck extension traction is commonly used for lower extremity fractures, particularly those involving the femur or hip in adolescents. It is a type of skin traction that helps to relieve muscle spasms and align the bone during the healing process.
B. Cervical skin: Cervical skin traction, such as a head halter, is used to provide traction to the cervical spine (neck) for conditions like muscle spasms or minor cervical fractures. It is not used for lower extremity fractures, as it applies force to the head and neck.
C. Dunlop: Dunlop traction is a type of skin traction specifically used for supracondylar fractures of the humerus in children. It involves the arm being positioned at a right angle to the body with traction applied in two directions. It is not indicated for lower extremity fractures..
D. Bryant: Bryant's traction is used primarily for young children with hip fractures or congenital hip issues. It involves elevating the buttocks off the bed and is not typically prescribed for adolescents with lower extremity fractures.