A nurse is preparing to acetaminophen 10/mg/kg PO to a preschool child for fever. The child 22 lb. Available is acetaminophen liquid 160 mg/5 Ml. How many mL should the nurse administer (Round the answer to nearest tenth. Use a leading zero if it applies. Do not use a trailing zero)

Choice A reason: A respiratory rate of 24/min is normal for a 3-year-old but does not specifically indicate rehydration success. Dehydration may cause tachypnea due to acidosis, but a normal rate is non-specific. Urine specific gravity better reflects fluid status, as it directly measures renal response to rehydration in diarrhea.

Choice B reason: Urine specific gravity of 1.015 indicates normal hydration, as kidneys produce appropriately concentrated urine after rehydration therapy corrects fluid loss in diarrhea. Values above 1.020 suggest persistent dehydration. This finding confirms effective restoration of fluid balance, making it the best indicator of successful oral rehydration in this child.

Choice C reason: Capillary refill greater than 3 seconds indicates poor perfusion, suggesting ongoing dehydration despite therapy. Effective rehydration restores perfusion, reducing refill time to less than 2 seconds. This finding suggests therapy failure, making it an incorrect indicator of successful oral rehydration in a child with diarrhea.

Choice D reason: A heart rate of 130/min suggests tachycardia, indicating persistent dehydration or stress in a 3-year-old, where normal rates are 80-120/min. Effective rehydration lowers heart rate by restoring volume. Urine specific gravity better confirms hydration status, making tachycardia an incorrect indicator of therapy success.

Choice A reason: Intussusception involves bowel telescoping, causing obstruction. A barium enema is the treatment of choice, as it applies hydrostatic pressure to reduce the invagination, restoring bowel continuity. This non-invasive method is effective in 80-90% of pediatric cases, avoiding surgical risks, and is prioritized unless perforation or peritonitis is present.

Choice B reason: IV fluids support hydration in intussusception but do not address the mechanical obstruction causing bowel ischemia. Fluids manage dehydration from vomiting or reduced intake, but only a barium enema or surgery corrects the telescoping, making fluids a supportive, not primary, treatment for resolving the underlying pathology.

Choice C reason: Immediate surgery is reserved for intussusception cases with perforation, peritonitis, or failed non-operative reduction. While effective, it carries risks like infection or adhesions. A barium enema is preferred as a less invasive option, successfully reducing the intussusception in most children, making surgery a secondary choice unless complications arise.

Choice D reason: Gastric lavage clears stomach contents but is irrelevant for intussusception, which involves intestinal obstruction. It does not reduce the telescoped bowel or relieve ischemia. A barium enema directly addresses the mechanical blockage, making lavage inappropriate, as it fails to correct the underlying anatomical issue causing the condition.