A child experiencing an allergic reaction receives a prescription for epinephrine 0.01 mg/kg SUBQ.

The child weighs 66 pounds, and the medication is labeled "Epinephrine 1mg/mL.”. How many mL should the practical nurse (PN) administer to this child? (Enter the numerical value only. If rounding is required, round to the nearest tenth.)

Choice A rationale

Excessive swallowing after a tonsillectomy is a critical sign of postoperative hemorrhage, as blood pooling in the pharynx triggers the swallowing reflex. Promptly informing the registered nurse allows for immediate assessment, potential intervention to control bleeding, and prevention of airway compromise or hypovolemic shock.

Choice B rationale

Offering fluids to soothe the throat is contraindicated in suspected hemorrhage as it may increase the risk of aspiration or obscure the amount of blood being swallowed. It also delays the critical assessment and intervention required for active bleeding.

Choice C rationale

Administering supplemental oxygen per prescription is a supportive measure for respiratory distress. While potentially necessary if the child's oxygen saturation drops, it does not address the underlying cause of excessive swallowing, which is likely hemorrhage, and should not be prioritized over reporting the cardinal sign.

Choice D rationale

Elevating the child's head to promote drainage is a general comfort measure and may help with swelling. However, it does not directly address active bleeding. In a suspected hemorrhage, the primary concern is to identify and manage the source of bleeding, not merely to promote drainage.

Choice A rationale

Administering ibuprofen may alleviate pain temporarily, but it does not address the underlying cause of increased pain and pressure, which could indicate a developing complication such as a perineal hematoma. Providing only symptomatic relief delays investigation and potential intervention for a serious issue.

Choice B rationale

Increased pain and pressure in the vaginal area following a perineal laceration, especially 6 hours postpartum, are classic signs of a developing perineal hematoma. This condition requires prompt medical evaluation by the healthcare provider to assess the extent of bleeding, potential for shock, and determine the need for surgical intervention.

Choice C rationale

Applying an icepack to the perineum is a common comfort measure for swelling and pain associated with lacerations. While it may provide some relief, it will not resolve a developing hematoma or significant internal bleeding that is causing increased pain and pressure. It is an insufficient intervention for the potential severity of the client's symptoms.

Choice D rationale

Providing routine perineal care, such as gentle cleansing and hygiene, is important for comfort and infection prevention. However, it does not address the acute and increasing pain and pressure that suggests a complication beyond typical postpartum discomfort. This intervention would delay necessary medical assessment for a potential hematoma.