A nurse is assisting with the care of a client.

Exhibits

The nurse is reinforcing teaching for the client and their family about potential adverse effects of the client's prescribed medications.

For each potential adverse effect, click to specify if the effect is. consistent with agranulocytosis, neuroleptic malignant syndrome, or. serotonin syndrome.

Each finding may support more than 1 disease process.

The correct answer is Choice B: Administer the medication to the toddler each evening.

Choice B rationale: Montelukast is a leukotriene receptor antagonist used for the long-term management of asthma, especially in preventing nighttime symptoms. It is typically prescribed to be administered once daily in the evening to provide optimal therapeutic benefits. By instructing the parents to give the medication each evening, the nurse promotes adherence to the prescribed dosing schedule and helps maximize the medication's effectiveness in controlling the toddler's asthma symptoms.

Choice A rationale: While some medications can be mixed with juice or other liquids to make them more palatable for children, montelukast should not be dissolved in a drink. Instead, it can be mixed with a spoonful of cold, soft food, such as applesauce or ice cream, if necessary, to facilitate administration. Mixing with juice could potentially alter the medication's efficacy or create an unpleasant taste.

Choice C rationale: Montelukast is not indicated for use as a quick-relief medication prior to physical activity. It is a maintenance medication intended for long-term asthma control rather than immediate relief of acute symptoms. Providing an additional dose of montelukast before physical activity would not serve the intended purpose and could increase the risk of side effects.

Choice D rationale: Montelukast is not meant to be used as a rescue medication for acute asthma attacks. It is a long-term control medication that helps prevent asthma attacks and improve overall symptom management. For acute asthma attacks, the toddler would require a fast-acting beta-agonist or other appropriate rescue medication prescribed by their healthcare provider. Administering montelukast during an acute asthma attack would not provide the rapid relief needed to alleviate symptoms and could potentially delay appropriate treatment.

Choice A rationale:

Elevating the head of the client's bed for 1 hour after the feeding is the correct choice because it helps reduce the risk of aspiration. Elevating the head of the bed at a 30-45 degree angle can promote the flow of enteral feeding solution into the jejunum, reducing the risk of reflux into the stomach and subsequent aspiration.

Choice B rationale:

Administering the feeding solution at a cold temperature is not recommended. Enteral feedings should be given at or near room temperature to prevent discomfort and cramping in the client.

Choice C rationale:

Rotating the jejunostomy tube once per day is not a standard practice. The tube should be secured in place to prevent dislodgement, but routine rotation is not necessary.

Choice D rationale:

Flushing the tube with 90 mL of sterile water before and after the feeding is not necessary for intermittent bolus enteral feedings. Flushing before and after continuous feedings may be required to maintain patency, but for intermittent bolus feedings, it is not a routine practice.