A nurse is caring for a toddler who is experiencing an acute asthma attack. Which of the following findings indicates improvement?

A. Clients on digoxin should actually have an adequate intake of potassium, as low potassium levels can increase the risk of digoxin toxicity.

B. If a pediatric client spits out digoxin, the dose should not be repeated automatically; instead, the nurse should assess the situation and follow the facility's protocol regarding missed doses.

C. Measuring the apical pulse for one full minute before administering digoxin is critical; if the pulse is below the established threshold (usually <60 bpm for children), the medication should be held and the provider notified.

D. While evaluating for nausea, vomiting, and anorexia is important, it is not an appropriate immediate action before administering the medication. The priority action is to assess the apical pulse.

The nurse should plan to include Target 1: administer acetaminophen or ibuprofen oral solution if needed for pain and Target 2: call provider if right leg feels cool to touch in comparison to left leg in the discharge instructions for the guardians.

Rationale:

• Administer acetaminophen or ibuprofen oral solution if needed for pain: This instruction is important for managing post-procedure discomfort and promoting the child's comfort.
• Call provider if right leg feels cool to touch in comparison to left leg: This is a critical instruction, as it can indicate potential complications like bleeding or thrombosis. Early identification of these issues is essential for timely intervention.

The other options are not appropriate for discharge teaching in this case:

• Remove pressure dressing four hours after discharge: This is typically done in the hospital setting under the supervision of healthcare professionals.
• Maintain clear liquid diet for 24 hr after discharge: A clear liquid diet may not be necessary after discharge, especially if the child is tolerating oral intake well.
• Tub bath is permitted 24 hr after procedure: While bathing is generally allowed after the procedure, specific instructions regarding water temperature and avoiding submerging the incision site should be provided.