A nurse is providing teaching to the parents of a school-age child newly diagnosed with a seizure disorder.
The nurse should teach the parents to take which of the following actions during a seizure?

Choice A rationale:

An increase in venous pressure is not an indication that furosemide, a loop diuretic, is effective. In fact, increased venous pressure could suggest worsening heart failure. Loop diuretics like furosemide work by promoting the excretion of excess fluid and sodium from the body, leading to a decrease in blood volume and relieving symptoms of heart failure, such as peripheral edema and pulmonary congestion.

Choice B rationale:

A decrease in cardiac output is not the desired effect of furosemide. Furosemide helps reduce fluid overload and congestion in the heart and lungs, ultimately improving cardiac output. If cardiac output decreases, it indicates that the medication might not be effective or the heart failure is worsening.

Choice C rationale:

An increase in potassium levels is not directly related to the effectiveness of furosemide. Furosemide can cause potassium depletion as it increases the excretion of potassium in the urine. Monitoring potassium levels is essential because severe hypokalemia can lead to cardiac arrhythmias. However, the absence of an increase in potassium levels does not indicate furosemide's effectiveness.

Choice D rationale:

A decrease in peripheral edema is the desired effect of furosemide. By reducing fluid retention, furosemide helps decrease peripheral edema, which is a common symptom of heart failure. The nurse should assess the child for a decrease in peripheral edema to determine the medication's effectiveness. Monitoring daily weights and assessing for reduced edema are key indicators of furosemide's efficacy.

Choice A rationale:

Attaching the feeding bag tubing to the end of the NG tube is a step in the enteral feeding process, but it is not the first action the nurse should take. First, the nurse needs to assess the pH of the gastric secretions to confirm the NG tube placement in the stomach. If the pH is acidic (usually below 5.5), it indicates that the NG tube is in the stomach. If the pH is alkaline, it may suggest the tube is in the respiratory tract, and feeding should not be initiated. Therefore, this choice is not the correct first action.

Choice B rationale:

Flushing the tube with water is important to ensure it is clear and not clogged. However, it is not the first action the nurse should take. Checking the pH of the gastric secretions is crucial to confirm the NG tube placement before any other interventions. If the nurse encounters resistance while flushing the tube, it could indicate a misplaced tube, emphasizing the importance of checking the pH first.

Choice C rationale:

Checking the pH of the gastric secretions is the correct first action before administering enteral feeding. Gastric secretions are acidic (usually below 5.5), confirming the tube's placement in the stomach. This step ensures the safety of the feeding process and prevents complications such as aspiration pneumonia. Once the placement is confirmed, the nurse can proceed with other steps, such as attaching the feeding bag tubing and setting the administration rate on the feeding pump.

Choice D rationale:

Setting the administration rate on the feeding pump is a necessary step in enteral feeding but should only be done after confirming the tube placement by checking the pH of the gastric secretions. If the nurse administers the feeding without confirming the tube placement, there is a risk of aspiration, which can be life-threatening.