A nurse is caring for a toddler who has acute laryngotracheobronchitis and has been placed in a cool mist tent. Which of the following findings should indicate to the nurse that the treatment is effective?

Choice A reason: Oral rehydration solution (ORS) is the best fluid for a child with acute gastroenteritis, as it contains the optimal balance of electrolytes and glucose to prevent dehydration and restore fluid balance. ORS is recommended by the World Health Organization (WHO) and the American Academy of Pediatrics (AAP) for the management of diarrhea in children.

Choice B reason: Water is not a good fluid for a child with acute gastroenteritis, as it does not contain any electrolytes or glucose and can dilute the blood sodium level, leading to hyponatremia. Water can also increase the osmotic load in the intestines and worsen diarrhea.

Choice C reason: Broth is not a good fluid for a child with acute gastroenteritis, as it is high in sodium and can cause hypernatremia and dehydration. Broth can also irritate the intestinal mucosa and increase diarrhea.

Choice D reason: Diluted apple juice is not a good fluid for a child with acute gastroenteritis, as it is high in fructose and can cause osmotic diarrhea. Apple juice can also lower the blood pH and cause metabolic acidosis.

Choice A reason: Withholding fluids until the client demonstrates a gag reflex is a preventive measure to avoid aspiration of liquids into the lungs. The gag reflex is a protective mechanism that prevents foreign objects from entering the airway. It can be impaired by anesthesia, surgery, or trauma. Therefore, the nurse should assess the client's gag reflex before offering fluids or food¹.

Choice B reason: Suctioning the nasopharynx as needed is another preventive measure to avoid aspiration of blood or secretions into the lungs. The nurse should monitor the client for signs of bleeding, such as frequent swallowing, restlessness, or bright red drainage. The nurse should also avoid stimulating the throat with tongue blades, straws, or suction catheters, as this can cause bleeding or spasm¹.

Choice C reason: Placing a bedside humidifier at the head of the client's bed is not a preventive measure to avoid aspiration, but rather a comfort measure to soothe the throat and reduce inflammation. Humidified air can help moisten the mucous membranes and promote healing. However, it does not prevent fluids or solids from entering the airway².

Choice D reason: Performing chest physiotherapy is not a preventive measure to avoid aspiration, but rather a treatment measure for clients who have respiratory complications, such as atelectasis or pneumonia. Chest physiotherapy involves percussion, vibration, and postural drainage to mobilize and remove secretions from the lungs. It is not indicated for clients who are postoperative following a tonsillectomy, as it can increase the risk of bleeding or pain³.

Choice E reason: Administering an antiemetic drug if the client is nauseous is a preventive measure to avoid aspiration of vomitus into the lungs. Nausea and vomiting are common postoperative complications that can be caused by anesthesia, pain, or opioids. The nurse should assess the client's nausea level and administer antiemetic drugs as prescribed. The nurse should also position the client on the side or with the head elevated to prevent aspiration¹.