The nurse is continuing to care for the adolescent.

Admission Assessment

1400:

Adolescent brought to emergency department by parents following a fall while skateboarding. Adolescent reports pain in their right leg as 10 on a scale of 0 to 10 and is unable to bear weight.

Adolescent is awake, alert, and oriented x 3. Lungs clear, respirations even and regular. S1 and S2 with regular rate and rhythm. Abdomen soft and nontender with active bowel sounds in all four quadrants. Right lower extremity with open wound and displaced bone. Right lower extremity pulse +1, extremity cool to touch, edema present, capillary refill 4 seconds.

Which of the following prescriptions should the nurse anticipate from the provider?

A. Correct. A 6-month-old infant who has croup and an O2 saturation of 92% on room air is at risk of respiratory distress and hypoxia. Croup causes inflammation and narrowing of the upper airway, which can compromise breathing. An O2 saturation of 92% is below the normal range of 95% to 100% and indicates inadequate oxygenation. This child needs immediate assessment and intervention to prevent further deterioration.

B. Incorrect. A 15-year-old adolescent who is 2 hr postoperative following an open reduction and internal fixation of the left ankle and is requesting pain medication has a priority need for pain management, but not as urgent as a child with respiratory compromise. The nurse should assess the adolescent's pain level, administer the prescribed analgesic, and monitor the effectiveness of the medication.

C. Incorrect. A 3-year-old toddler who has gastroenteritis, moderate dehydration, and had two loose bowel movements over the past 24 hr has a potential risk for fluid and electrolyte imbalance, but not as acute as a child with respiratory compromise. The nurse should monitor the toddler's intake and output, vital signs, weight, and skin turgor, and administer oral or intravenous fluids as prescribed.

D. Incorrect. A 10-year-old child who is awaiting surgery for an appendectomy and experienced sudden relief from pain may have a perforated appendix, which can lead to peritonitis and sepsis. However, this child is not as unstable as a child with respiratory compromise. The nurse should notify the surgeon of the change in pain status, monitor the child's vital signs, abdominal assessment, and laboratory results, and prepare the child for surgery.

To calculate the total volume to be administered each day:

1. Dosage per administration: 30 mg
2. Frequency: Every 12 hours (twice a day)
3. Volume per administration: 0.3 mL (since 30 mg is in 0.3 mL)

The total volume per day is:

0.3mL×2=0.6mL

Therefore, the practical nurse should administer 0.6 mL each day.