A nurse is caring for a group of children. Which of the following children should the nurse recognize as at risk for developing acute poststreptococcal glomerulonephritis?

Rationale:

A. Digoxin should not be mixed with large volumes of liquid or food because if the child does not finish the entire mixture, the full dose may not be received. It should be given directly using an oral syringe, and if needed, a small amount of liquid can be used to mask the taste, ensuring the full dose is administered.

B. The dose should not automatically be repeated because digoxin has a narrow therapeutic index and re-dosing can lead to toxicity. If vomiting occurs, the nurse or provider should be notified for further instructions rather than independently repeating the dose.

C. Giving a small amount of water after administering digoxin helps ensure the full dose is swallowed and reduces the risk of the medication remaining in the mouth or being absorbed unevenly. This is a safe and appropriate teaching point for parents.

D. Digoxin toxicity is actually worsened by hypokalemia, not excess potassium intake. In clients taking digoxin, maintaining normal potassium levels is important because low potassium increases the risk of digoxin toxicity. Potassium is not routinely restricted unless otherwise indicated.

Rationale:

A. Disulfiram is used in alcohol use disorder to deter alcohol intake by causing unpleasant effects when alcohol is consumed. It has no role in treating opioid (morphine) toxicity.

B. Activated charcoal may be used in certain oral poisonings if given shortly after ingestion, but it is not the primary treatment for opioid toxicity. Additionally, in opioid overdose with respiratory depression, airway and breathing support plus an antidote are priorities over decontamination measures.

C. Flumazenil is a benzodiazepine antagonist used to reverse benzodiazepine overdose. It does not reverse opioid effects and is not effective for morphine toxicity.

D. Naloxone is an opioid antagonist that rapidly reverses the effects of opioids such as morphine. It competes with opioids at receptor sites, reversing respiratory depression, sedation, and hypotension associated with opioid toxicity. It is the first-line antidote in suspected opioid overdose and should be administered promptly.