A nurse is preparing a 9-year-old child for an IV catheter insertion. Which of the following actions should the nurse take first?

Convert the child's weight from pounds (lb) to kilograms (kg):

20 lb × (1 kg / 2.20462 lb) ≈ 9.07 kg

Calculate the total daily dose of cefazolin:

Total daily dose = 30 mg/kg/day × 9.07 kg = 272.1 mg/day

Divide the total daily dose into two equal doses:

Each dose = 272.1 mg / 2 ≈ 136.05 mg

Determine the dose per ml using the available oral suspension concentration:

125 mg/5 ml = 25 mg/ml

Calculate the volume of oral suspension needed for each dose:

Volume per dose = Dose per dose / Concentration per ml

≈ 136.05 mg / 25 mg/ml

≈ 5.44 ml

So, the child should receive approximately 5.44 ml per dose of cefazolin oral suspension.

A. Withhold opioids to avoid dependence.

This option is incorrect. Opioid analgesics are commonly used to manage the severe pain associated with sickle cell crisis. Withholding opioids during a crisis could lead to inadequate pain relief and compromise the adolescent's comfort and recovery. It's important to appropriately administer opioids as prescribed to alleviate pain and suffering.

B. Assist RN with administering a blood transfusion.

This option may be appropriate depending on the severity and indications of the sickle cell crisis. Blood transfusions are sometimes used to treat sickle cell crises, particularly in cases of severe anemia or acute complications such as acute chest syndrome. However, the decision to administer a blood transfusion should be made by the healthcare provider based on the individual patient's clinical status and needs. The nurse's role would include assisting the registered nurse (RN) with the administration of the transfusion and monitoring the adolescent for any adverse reactions.

C. Initiate a 2 L/day fluid restriction.

This option is incorrect. During a sickle cell crisis, it is important to maintain adequate hydration to help prevent dehydration and reduce the viscosity of blood, which can help prevent sickling of red blood cells. Fluid intake should be encouraged, and there is typically no need for fluid restriction unless there are specific medical reasons to do so.

D. Encourage exercise.

This option is incorrect. During a sickle cell crisis, the adolescent is likely experiencing significant pain and discomfort, which may limit their ability to engage in physical activity. Encouraging exercise during a crisis could exacerbate pain and potentially lead to complications. Rest and minimizing physical exertion are typically recommended during a sickle cell crisis to promote comfort and conserve energy.