A 3-year-old is admitted to the pediatric unit with a traumatic injury to the right forearm. The mother had been giving the child aspirin at home to control pain and fever
Approximately 3 weeks prior to admission, the child had an upper respiratory infection. The mother asks the nurse why the doctor changed the child's medication from aspirin to acetaminophen. What is the nurse's best response?
1. "Typically, aspirin is a safe salicylate for children of any age."
2. "Acetaminophen is given to children for inflammation and fever when there is a recent or current history of a viral infection, due to the risk of Reye's syndrome."
3. "I really do not know, but I am certain the health care provider has a good reason."
4. "It would be important for the doctor to allow you to continue to medicate your child, since there is a strong level of trust between mother and child."
Correct Answer: 2
Rationale 1: Aspirin is not always safe for children.
Rationale 2: Aspirin should not be given to children who have or have had a viral infection, due to the risk of Reye's syndrome. If a child has a recent or current history of viral infection, the aspirin should be changed to acetaminophen.
Rationale 3: The nurse has not answered the mother's question.
Rationale 4: Once the child is admitted to the hospital, it is the health care provider's responsibility to assess and manage the treatment of inflammation and fever. Although trust and rapport are extremely important, and the child would have more trust in the mother than in health care professionals, allowing continued self-medication would not be recommended.
Global Rationale: Children under age 19 should never be administered products that contain aspirin when they have flu symptoms, fever, or chickenpox, due to the risk of Reye's syndrome, a potentially fatal disease. It is unclear how aspirin contributes to Reye's syndrome, because the condition can appear without aspirin use. The incidence of Reye's syndrome is now very rare due to public awareness of the risk associated with aspirin use. Once the child is admitted to the hospital, it is the health care provider's responsibility to assess and manage the treatment of inflammation and fever. Although trust and rapport are extremely important, and the child would have more trust in the mother than in health care professionals, allowing continued self-medication would not be recommended.
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