A nurse is providing teaching to an adolescent who has a new prescription for cefazolin. For which of the following adverse effects should the nurse instruct the adolescent to monitor and report to the provider?

A. Decreased respiratory rate: AKI typically does not directly affect respiratory rate. Respiratory rate is more closely related to lung function and oxygenation status rather than kidney function.

B. Polyuria: This is an incorrect option. Polyuria, or increased urine output, is not typically seen in acute kidney injury. In fact, oliguria (decreased urine output) or anuria (absence of urine output) are more common in AKI due to decreased kidney function.

C. Hyperactivity: AKI does not typically cause hyperactivity. In fact, children with AKI may appear lethargic or fatigued due to the buildup of waste products in their bodies and electrolyte imbalances.

D. Edema: This is the correct option. Edema, or swelling due to fluid retention, is a common clinical manifestation of AKI. When the kidneys are unable to adequately filter and excrete excess fluid from the body, fluid accumulates in the tissues, leading to edema. Edema may be particularly noticeable in the face, hands, feet, or around the eyes.

A. Initiate antibiotic therapy for the child.

This is the priority action. Bacterial meningitis is a medical emergency, and prompt administration of antibiotics is crucial to treat the infection and prevent further complications. Therefore, the nurse should initiate antibiotic therapy as soon as possible after obtaining appropriate cultures.

B. Minimize the child's environmental stimuli.

While reducing environmental stimuli can help decrease the child's discomfort and prevent agitation, it is not the priority action when managing bacterial meningitis. Treating the underlying infection takes precedence to prevent serious complications such as neurological damage or septic shock.

C. Place the child in a side-lying position.

Positioning the child on their side may help prevent aspiration if vomiting occurs, but it is not the priority action in the initial management of bacterial meningitis. The child's positioning can be adjusted as needed once antibiotic therapy has been initiated.

D. Administer pain medication to the child.

Pain management is important for the child's comfort, but it is not the priority action when managing bacterial meningitis. The child's pain may be addressed once antibiotic therapy has been initiated and the child's condition has stabilized.