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. Place the child in a room with bright fluorescent lighting.

This option is not appropriate because bright fluorescent lighting can be uncomfortable and potentially aggravate symptoms such as headache or sensitivity to light, which are common after a head injury. Therefore, it is not included in the plan of care.

B. Initiate seizure precautions for the child.

This intervention is appropriate because children with head injuries are at an increased risk of seizures. Seizure precautions may include ensuring a safe environment, such as padding the sides of the bed, removing any objects that could cause harm during a seizure, and closely monitoring the child's neurological status for signs of seizure activity.

C. Use the COMFORT scale to rate the child's pain.

While assessing and managing pain is important, the COMFORT scale may not be the most appropriate tool for evaluating pain in a child with a head injury. The nurse should use a pain assessment tool that is specifically designed for pediatric patients and is suitable for assessing pain in children with head injuries.

D. Suction the child's nares to determine the presence of fluid.

Suctioning the child's nares may be indicated if there are concerns about airway patency or respiratory secretions. However, it is not a routine intervention for all children with head injuries. The nurse should assess the child's respiratory status and use suctioning only if necessary based on clinical findings.

A. Decreased calories:

During illness, it's important to ensure adequate calorie intake to meet the body's increased energy demands for fighting off infection. Decreasing calories is not appropriate and can lead to hypoglycemia in a child with diabetes mellitus.

B. Increased fluids:

This is the correct option. During illness, the body's fluid requirements increase due to fever, sweating, and increased urination. Providing increased fluids helps prevent dehydration, which can exacerbate hyperglycemia. Parents should encourage the child to drink plenty of water or other sugar-free fluids to stay hydrated.

C. Blood glucose monitoring every 8 hr:

During illness, blood glucose levels may fluctuate more than usual due to changes in food intake, activity level, and the body's response to stress. Therefore, more frequent blood glucose monitoring is necessary, typically every 2-4 hours or as directed by the healthcare provider, rather than every 8 hours.

D. Urine testing for leukocytes:

Urine testing for leukocytes is not directly related to managing diabetes mellitus during illness. It may be done to assess for urinary tract infections, which can occur more frequently in individuals with diabetes, but it is not a routine part of diabetes management during illness.