Three-year-old C.E. is admitted to the Emergency Department (ED) fast track clinic. Her mother tells the nurse that C.E. has had a low-grade fever for 2 days and is complaining of ear pain and a sore throat. Mrs. E. states that C.E.’s appetite has been “off,” but she has been drinking and using the bath- room as usual.
Mrs. E. takes C.E. to an ENT specialist. It is determined that her enlarged tonsils might be contributing to the frequent throat and ear infections, and a tonsil and adenoidectomy (T&A) is scheduled. She will be admitted postoperatively for 24-hour observation.
After the surgery, the postoperative nurse receives C.E. to the short-stay unit from the post-anesthesia care unit (PACU). C.E. is awake and alert, bilateral breath sounds are clear, and her oxygen saturation is 98% on room air. She has tolerated sips of clear fluids, and her parents are with her.
8.  Which of these orders would you expect to see in her postoperative orders? (Select all that apply, and discuss the rationales for your choices.)
a.  Vital signs q4h
b.  Clear liquids. Advance to regular toddler diet.
c.  Methylprednisolone (Solu-Medrol) 2.3 mg IV q8h ´ 3 doses
d.  Acetaminophen (Tylenol) (120 mg) with codeine (12.5 mg) 5 mL PO q6h prn for pain
e.  Home prescription for amoxicillin (Amoxil) 120 mg PO q8h
f.  Maintain peripheral IV with D51„2 NS at 50 mL/hr until taking PO well and then saline lock
g.  Aggressively gargle and swish with water after eating or drinking.