A nurse is reinforcing teaching with a client who is 12 hr postpartum and has an episiotomy. Which of the following instructions should the nurse include?

Montelukast is a medication commonly prescribed for the management of asthma symptoms, including the prevention of asthma attacks. The recommended dosing regimen for montelukast is typically once daily, usually in the evening. This helps to provide continuous control of asthma symptoms and reduce the risk of asthma exacerbations.

Administer the medication when the toddler has an acute asthma attack: Montelukast is not intended for immediate relief during an acute asthma attack. It is a long-term control medication aimed at preventing asthma symptoms and reducing the frequency and severity of attacks. For acute asthma attacks, a short-acting bronchodilator such as albuterol is typically used.

Provide an additional dose of the medication prior to physical activity: Montelukast is not specifically indicated as a pre-exercise medication for asthma. However, in some cases, healthcare providers may prescribe it if exercise-induced bronchoconstriction is a significant concern. It is important to follow the specific instructions provided by the healthcare provider regarding medication use before physical activity.

Mix the medication in juice prior to administration: Montelukast tablets or chewable tablets should not be crushed or mixed in juice unless specifically instructed by the healthcare provider. They should be administered whole and taken with water. If the child has difficulty swallowing tablets, alternative formulations like oral granules or chewable tablets may be available.

b. A decreased level of consciousness and vomiting

Explanation:

When receiving report on four clients, the nurse should first collect data about the client who has a decreased level of consciousness and vomiting. This combination of symptoms suggests a potentially serious condition that requires immediate atention and assessment. It could indicate a neurological or gastrointestinal issue, and further evaluation is necessary to determine the underlying cause and provide appropriate interventions.

Explanation for the other options:

a. Cellulitis accompanied by a low-grade fever:

While cellulitis and a low-grade fever require atention, they are not as immediately critical as a decreased level of consciousness and vomiting. The nurse should prioritize assessing the client with altered consciousness and vomiting due to the potential for more urgent interventions.

c. A pain rating of 7 on a scale from 0 to 10 after receiving analgesia 30 min ago:

Although the client's pain rating of 7 indicates ongoing pain, it is not as immediately critical as a decreased level of consciousness and vomiting. The nurse should first address the client with altered consciousness to determine the cause and provide appropriate interventions before assessing and managing pain in other clients.

d. Type 2 diabetes mellitus and a blood glucose level of 160 mg/dL:

While elevated blood glucose levels in a client with type 2 diabetes require atention and management, they are not as immediately critical as a decreased level of consciousness and vomiting. The nurse should first assess the client with altered consciousness to identify the cause and provide prompt interventions.

In summary, when receiving report on four clients, the nurse should first collect data about the client who has a decreased level of consciousness and vomiting. These symptoms indicate a potentially serious condition requiring immediate assessment and intervention.