A six-year-old girl is brought to the emergency department. She has a "frog-like croaking sound" on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should first do which of the following?

Choice A reason: This is not a relevant question for the admission history, as it does not address the child's current condition or treatment plan. It may also be perceived as insensitive or judgmental by the parents.

Choice B reason: This is not a pertinent question for the admission history, as it does not relate to the child's medical history or needs. It may also be seen as intrusive or irrelevant by the parents.

Choice C reason: This is an appropriate question for the admission history, as it acknowledges the cultural beliefs and practices of the parents and the child. It also helps the nurse to identify any potential interactions or conflicts between the tribal healer's recommendations and the medical treatment.

Choice D reason: This is a valid question for the admission history, as it informs the nurse of any alternative therapies or substances that the child may have received or ingested. It also helps the nurse to assess the effectiveness and safety of the herbal remedies, and to prevent any adverse effects or interactions with the prescribed medications.

Choice A reason: Calling the physician is not the first action because it would delay the immediate intervention of oxygen administration, which is critical for a patient with hypoxia. The physician should be notified after initiating oxygen therapy and assessing the patient's condition.

Choice B reason: Placing the patient on 10 L/min oxygen per nasal cannula is not the first action because it is too high of a flow rate for a two-year-old patient, and it could cause oxygen toxicity or barotrauma. The appropriate oxygen delivery device and flow rate should be determined based on the patient's age, weight, and clinical status.

Choice C reason: Assessing the patient is not the first action because it would also delay the immediate intervention of oxygen administration. The patient's pulse oximetry reading indicates severe hypoxia, which requires prompt treatment to prevent organ damage or death. The patient should be assessed after initiating oxygen therapy and monitoring vital signs.

Choice D reason: Administering oxygen and monitoring vital signs while calling the physician is the correct answer because it provides the most effective and timely response to the patient's hypoxia. Oxygen administration improves the patient's oxygen saturation and tissue perfusion, while vital sign monitoring helps to evaluate the patient's response to therapy and identify any complications. Calling the physician informs them of the situation and allows them to order further interventions or tests as needed.

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