A nurse is caring for a child who is 2 hr postoperative.

Exhibits

Which of the following actions should the nurse take first? (Click the "Exhibit" button for additional information about the client. There are three tabs that contain separate categories of data.)

A. This is the first and most critical action to take. If the dressing is saturated with blood, it indicates that there may be active bleeding at the catheter insertion site. Applying direct pressure just above the insertion site helps control bleeding by promoting clot formation and reducing blood flow to the area.
B. Monitoring the pulse distal to the insertion site is important for assessing blood flow and identifying potential complications such as arterial occlusion or hematoma formation. However, it is not the first action to take when there is active bleeding. While this assessment is important, controlling the bleeding takes precedence.

C. Obtaining vital signs is important for assessing the child’s overall condition and identifying signs of potential hemodynamic instability. However, it is not the first step when there is immediate, active bleeding. Addressing the bleeding directly is more urgent to prevent further complications.
D. Reinforcing the dressing might be necessary if the bleeding has been controlled. However, if the dressing is already saturated, simply reinforcing it without addressing the underlying bleeding issue may not be effective and could delay necessary intervention.

A. Furosemide is a diuretic that helps to reduce fluid volume, which would lead to a decrease in venous pressure, not an increase.
B. Furosemide is primarily used to reduce fluid retention (edema). A decrease in peripheral edema indicates that the medication is working effectively.
C. Furosemide can actually cause hypokalemia (low potassium levels) as a side effect.
D. Furosemide is used to improve cardiac output by reducing the fluid overload that puts a strain on the heart.