The nurse is caring for a child who is receiving a narcotic for pain relief. Which of the following assessment should be a priority in monitoring the child (select all that apply)?

A. Brian playing with his truck next to Kristina playing with her truck

This scenario describes parallel play. In parallel play, children play near each other but engage in their own activities without direct interaction.

B. Adam playing a board game with Kyle, Steven, and Erich

This scenario describes interactive or cooperative play, where children play together, sharing an activity and interacting.

C. Danielle playing with a music box on her mother's lap

This scenario represents a form of one-on-one play with a parent, which is not parallel play.

D. Kimberly and Amanda sharing clay to each make things

This scenario describes interactive or cooperative play, as the children are sharing materials and engaging in a joint activity.

A. The child's current vital signs are consistent with vital signs over the past 4 hours.

Vital signs alone may not be sufficient to assess pain in a child. Children may experience pain without significant changes in vital signs. Behavioral cues and self-reporting are important indicators of pain in pediatric patients.

B. The child becomes quiet when held and cuddled.

While seeking comfort through cuddling may be a sign of distress or discomfort, it is not specific enough to determine the need for pain medication. Additional assessment is required to understand the underlying cause of the child's change in behavior.

C. The child has a temperature of 38.5°C.

Fever alone does not necessarily indicate the need for pain medication. It may suggest an infection or illness, but the specific assessment of pain requires consideration of the child's behavior, verbal expressions, and any other cues related to pain.

D. The child is lying stiffly in bed, not moving, and refusing to get up.

In this scenario, the child's behavior of lying stiffly in bed, not moving, and refusing to get up is indicative of potential pain. Children may express pain in various ways, and behavioral cues such as changes in activity, refusal to move, or guarding certain body parts can suggest discomfort. It is important for the nurse to assess and address the child's pain promptly.