A child with acute glomerulonephritis is experiencing hematuria.
Which intervention is most appropriate?

Choice A rationale

Observing for signs of respiratory distress is the priority assessment for a child with burns to the face and neck. Burns in this area can lead to airway edema and compromise, which can rapidly become life-threatening. Assessing for stridor, hoarseness, difficulty breathing, and changes in respiratory rate and effort is crucial for immediate intervention.

Choice B rationale

Monitoring vital signs for indications of shock is important in burn patients due to fluid shifts and potential hypovolemia. However, airway patency takes precedence, as inadequate oxygenation will quickly lead to irreversible damage. Vital signs should be monitored continuously after ensuring the airway is secure.

Choice C rationale

Obtaining a detailed history of the burn incident is necessary for understanding the mechanism of injury and potential associated trauma. However, the immediate priority is to assess and manage any threats to the child's airway, breathing, and circulation. History taking can occur once the child is stable.

Choice D rationale

Evaluating the extent and depth of the burns is crucial for determining the severity of the injury and guiding fluid resuscitation and wound care. However, ensuring a patent airway and adequate breathing is the immediate priority upon the child's arrival in the emergency department.

Choice A rationale

For a withdrawn 4-year-old, activities that allow for self-expression and communication are beneficial. Coloring provides a non-verbal outlet for emotions, and talking about feelings, facilitated by the nurse, can help the child process their experience and reduce feelings of isolation.

Choice B rationale

Practicing reading skills is developmentally appropriate for some 4-year-olds but may not be engaging or therapeutic for a child who is currently withdrawn and emotionally distressed due to hospitalization. The focus should be on emotional expression rather than academic tasks.

Choice C rationale

Watching cartoons alone can increase feelings of isolation and does not encourage interaction or emotional expression, which are crucial for a withdrawn child in a hospital setting.

Choice D rationale

While rest is important, frequent napping can further isolate the child and may not address the underlying emotional needs contributing to their withdrawal. Encouraging active engagement and interaction is more therapeutic.