A nurse is caring for a child who is 2 hours postoperative following a tonsillectomy. Which of the following fluid items should the nurse offer the child at this time?

Choice A: A 10-year-old child who has sickle cell anemia and reports severe chest pain should be assessed first, as this is a sign of acute chest syndrome, which is a life-threatening complication of sickle cell disease. Acute chest syndrome occurs when sickle-shaped red blood cells block the blood flow to the lungs, causing hypoxia, inflammation, and infection. Acute chest syndrome can lead to respiratory failure, pulmonary hypertension, or stroke.

Choice B: A 7-year-old child who has diabetes insipidus and a urine specific gravity of 1.016 should be assessed second, as this is a sign of dehydration, which is a common complication of diabetes insipidus. Diabetes insipidus is a condition in which the body does not produce enough antidiuretic hormone (ADH) or does not respond to it properly, resulting in excessive urination and thirst. Dehydration can cause electrolyte imbalance, hypotension, or shock.

Choice C: A 4-year-old child who has asthma and an O2 sat of 97% should be assessed third, as this is a sign of adequate oxygenation, which is a desired outcome of asthma management. Asthma is a condition in which the airways become inflamed, narrow, and produce excess mucus, causing difficulty breathing, wheezing, coughing, or chest tightness. Asthma can be triggered by allergens, irritants, exercise, or infections.

Choice D: A 1-year-old toddler who has roseola and a temperature of 39°C/102.2°F should be assessed last, as this is a sign of a mild viral infection, which is self-limiting and usually resolves within a week. Roseola is a common childhood illness that causes a high fever followed by a pink rash on the trunk, face, and limbs. Roseola can also cause irritability, swollen lymph nodes, or mild diarrhea.

Choice A: Allowing the child to keep a toy from home with her can help reduce her fear and anxiety by providing comfort, distraction, and familiarity. This strategy can also enhance the child's sense of control and autonomy by letting her choose what toy to bring.

Choice B: Using mummy restraints during painful procedures can increase the child's fear and anxiety by making her feel trapped, helpless, and powerless. This strategy can also damage the child's trust and cooperation with the nurse and cause psychological trauma.

Choice C: Having a parent stay with the child during procedures can help reduce her fear and anxiety by providing support, reassurance, and security. This strategy can also enhance the child's coping skills and resilience by modeling calm and positive behaviors.

Choice D: Planning invasive procedures whenever possible can increase the child's fear and anxiety by exposing her to unnecessary pain and discomfort. This strategy can also impair the child's physical and emotional development by causing stress and inflammation.

Choice E: Performing the procedure as quickly as possible can help reduce her fear and anxiety by minimizing the duration and intensity of pain. This strategy can also enhance the child's satisfaction and compliance by showing respect and empathy.