A nurse is preparing to administer acetaminophen 10mg/kg PO to a preschool child for fever.

The child weighs 22 lb. Available is acetaminophen liquid 160 mg/5 mL. How many mL should the nurse administer? .

The correct answer is (C) Determine if the toddler is voiding.

Choice A: Initiate isotonic fluids with 20 mEq/L potassium chloride. While it is important to maintain hydration in a child with acute gastroenteritis, initiating isotonic fluids with 20 mEq/L potassium chloride is not the first action a nurse should take. The child’s hydration status and electrolyte balance need to be assessed first. The American Academy of Pediatrics recommends the use of isotonic solutions with adequate potassium chloride and dextrose for maintenance IV fluids in children.

Choice B: Collect a stool sample from the toddler Collecting a stool sample can help identify the cause of the gastroenteritis. However, this is not the first step. The stool sample collection should be done using a clean, dry toilet hat or plastic wrap. But before this, the child’s hydration status needs to be assessed.

Choice C: Determine if the toddler is voiding The first action the nurse should take when using the nursing process is assessment. Therefore, checking if the toddler is voiding is the priority. This will help assess the child’s hydration status, which is critical in managing acute gastroenteritis.

Choice D: Request evaluation of the toddler’s serum electrolytes Requesting an evaluation of the toddler’s serum electrolytes is also important, but it’s typically done after the initial assessment. Fluid and electrolyte derangement are the immediate causes that increase the mortality in diarrhea. However, before requesting this evaluation, the nurse should first determine if the toddler is voiding to assess the child’s hydration status.

Step 1 is to convert the child’s weight from pounds to kilograms.

This is done by dividing the weight in pounds by 2.2, so 34 lbs ÷ 2.2 = 15.45 kg. Step 2 is to calculate the dose in mg. This is done by multiplying the weight in kg by the dosage per kg, so 15.45 kg × 35 mg/kg = 540.75 mg. Step 3 is to convert the dose in mg to ml. This is done by dividing the dose in mg by the concentration of the medication in mg/ml, so 540.75 mg ÷ 50 mg/ml = 10.815 ml. So, the total daily dosage in ml for this child is approximately 10.82 ml, rounded to the nearest hundredth as required.