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WorksheetsNC1 SET 4
Total questions: 75
Worksheet time: 4hrs 20mins
Postpartum day 3, a client has BP 166/110, severe headache, and blurred vision. What is the first nursing action?
Institute seizure precautions and start magnesium per protocol
Obtain a 24-hour urine collection for protein quantification
Encourage oral fluids and reassess symptoms later
Prepare oxytocin infusion for expedited uterine involution
A laboring client on magnesium sulfate becomes somnolent with RR 8/min, absent reflexes, and urine 15 mL/hr. What is the priority?
Stop magnesium, give calcium gluconate per protocol, and support ventilation
Increase magnesium rate to prevent seizures from recurring
Restrict all fluids and wait for a spontaneous recovery
Administer an opioid for comfort and observe for improvement
Immediately after birth, the uterus is firm and midline, but bleeding is brisk and bright red. What is the best nursing interpretation?
Genital tract laceration likely; prepare for examination and repair
Uterine atony likely; begin high-dose uterotonics immediately
Bladder distention likely; perform immediate catheterization
Retained placenta likely; prepare for manual removal now
During labor, a client develops sudden hypoxia, hypotension, and DIC without warning. What is the priority nursing response?
Call a code, deliver high-flow oxygen, support circulation, and activate massive transfusion protocol
Place the client in Trendelenburg and await spontaneous recovery
Administer a diuretic to reduce pulmonary edema risk
Provide oral fluids while arranging a chest radiograph
A 31-week client has preterm labor with intact membranes and no infection. Which nursing actions are appropriate now? Select all that apply.
Arrange antenatal corticosteroids for fetal lung maturity
Consider tocolysis to allow completion of the steroid course
Begin routine digital cervical examinations every hour
Obtain GBS screen and avoid unnecessary vaginal exams
Discharge home with strict bed rest and no medications
Post-cesarean day 1, a client has pleuritic chest pain, tachycardia, and SpO₂ 90%. What is the first nursing action?
Apply oxygen, elevate the head, notify provider, and prepare for diagnostic imaging
Encourage brisk ambulation to mobilize the suspected clot
Massage the calf to improve venous return and comfort
Offer oral fluids and reassess oxygen saturation later
A TOLAC client on low-dose oxytocin reports sudden tearing pain between contractions with vaginal bleeding and loss of station. What is the priority?
Encourage active pushing to restore fetal descent
Stop oxytocin and call an obstetric emergency immediately
Start amnioinfusion to relieve variable decelerations
Obtain a urine ketone test to rule out dehydration
A postpartum client with asthma has uterine atony after oxytocin. Which nursing actions are appropriate now? Select all that apply.
Perform bimanual massage and ensure bladder emptying
Administer misoprostol per rectum as ordered
Give tranexamic acid within 3 hours of birth if not contraindicated
Administer carboprost IM despite the asthma history
Prepare uterine balloon tamponade if bleeding persists
A 35-week client has intense nocturnal pruritus of palms and soles; bile acids return at 60 μmol/L. What is the best nursing plan today?
Notify the provider, support symptom therapy, arrange fetal surveillance, and discuss delivery timing near 36-37 weeks
Reassure that itching is benign and continue routine prenatal care
Begin magnesium sulfate prophylaxis to reduce seizure risk
Delay all surveillance because fetal risk is minimal at this stage
Six weeks postpartum after GDM, a client asks about diabetes follow-up. What is the most accurate teaching?
A random glucose today is sufficient to exclude diabetes long term
Schedule a 75-g OGTT at 4-12 weeks postpartum and screen every 1-3 years thereafter
Discontinue all screening because insulin needs ended after delivery
Use home capillary checks only when symptoms of diabetes appear
A 32-week client is rear-end MVC victim and arrives on a backboard. Which initial nursing actions are correct? Select all that apply.
Prioritize ABCs with maternal stabilization first
Apply left uterine displacement to reduce vena cava compression
Initiate fetal monitoring when maternal status permits
Delay Rh testing until discharge regardless of blood type
Assess for bleeding and obtain type and screen with indicated labs
Postpartum day 5, a client has orthopnea, S3, and bibasilar crackles. What is the best nursing action?
Encourage aggressive oral fluids to increase milk supply
Elevate the head, give oxygen, and notify cardiology for heart-failure management
Apply warm compresses and reassess in the morning
Restrict all activity until symptoms resolve spontaneously
After an assisted birth with a fourth-degree laceration, which nursing plan is most appropriate today?
Daily rectal temperatures and stimulant laxatives for regularity
Perineal hygiene, pain control, stool softener, fiber, and avoidance of rectal procedures
Early enemas to prevent fecal stasis and wound strain
High-impact exercise to restore pelvic tone rapidly
Which intrapartum situations require GBS intrapartum prophylaxis? Select all that apply.
Unknown GBS status with intrapartum fever ≥38 °C
Unknown GBS status with ROM ≥18 hours at term
Prior GBS colonization in a previous pregnancy now testing negative
History of a prior infant with early-onset GBS disease
GBS bacteriuria at any time during the current pregnancy
During third stage, the uterus inverts after traction. What is the best immediate nursing action?
Call for help, stop uterotonics, and prepare for immediate manual replacement
Continue fundal massage to restore the uterine shape
Start high-dose oxytocin infusion before any manipulation
Place the patient sitting up and reassess bleeding later
A 39-week induction order includes misoprostol for a client with a prior low-transverse cesarean. What should the nurse do first?
Question the order and notify the provider due to uterine rupture risk
Administer the dose and document informed consent
Replace misoprostol with high-dose oxytocin immediately
Begin amniotomy to accelerate cervical ripening
A breastfeeding parent on therapeutic LMWH for DVT asks about feeding safety. What is the best response?
Stop anticoagulation because all agents pass into milk significantly
Continue breastfeeding; LMWH is compatible with lactation; review bleeding precautions
Switch to a direct oral anticoagulant to reduce injection burden
Discontinue breastfeeding until anticoagulation is completed
During a confidential prenatal visit, a client discloses intimate partner violence. Which nursing actions are appropriate today? Select all that apply.
Ensure private, trauma-informed assessment and document objectively
Create a safety plan and provide local resources discreetly
Clarify reporting requirements and obtain consent where applicable
Confront the partner to obtain an admission of guilt
Offer follow-up and referrals while respecting the client's choices
A first-trimester screen shows asymptomatic bacteriuria (≥10⁵ CFU/mL). What is the best nursing plan?
Start appropriate antibiotics and arrange a test-of-cure culture
Observe without therapy unless dysuria develops later
Use cranberry juice alone for seven days and repeat testing
Delay treatment until the second trimester ultrasound
A family learns of an intrauterine fetal demise at 35 weeks. What is the most appropriate nursing action?
Provide privacy, offer memory-making options, and facilitate bereavement support
Discourage parental holding to avoid traumatic recall later
Focus on rapid discharge to minimize hospital exposure
Avoid discussing lactation because the topic is distressing
At discharge, a client asks about postpartum preeclampsia warning signs. Which teaching points should the nurse emphasize? Select all that apply.
Severe headache, visual changes, or RUQ/epigastric pain
Shortness of breath, chest pain, or sudden swelling
Oliguria or a rapid rise in blood pressure readings
Mild mood lability during the first week only
Seizure or fainting-call emergency services immediately
A mother on stable methadone therapy asks about breastfeeding. What is the best nursing guidance?
Avoid breastfeeding until methadone taper is complete
Breastfeeding is encouraged if no other contraindications; coordinate NAS monitoring and follow-up
Switch to mixed formula to lower neonatal exposure
Discontinue methadone to enable immediate breastfeeding
Before an operative vaginal birth, which bedside checks should the nurse confirm? Select all that apply.
Complete dilation and ruptured membranes
Engaged head with known position and adequate pelvis
Empty bladder and adequate analgesia or anesthesia
Maternal exhaustion is present with no contraindications
Informed consent and emergency backup available
At 3 cm/-3 station, the head is unengaged and the plan is amniotomy. What is the best nursing action?
Proceed with amniotomy to accelerate descent
Advise deferring amniotomy due to prolapse risk and notify the provider
Apply fundal pressure to encourage rapid engagement
Start high-dose oxytocin before confirming engagement
A postpartum hemorrhage reaches 1500 mL with hypotension and coagulopathy. What is the priority nursing response?
Activate massive transfusion protocol, warm products, trend labs, and administer calcium per protocol
Wait for the next hemoglobin value before transfusing
Give high-dose diuretics to reduce interstitial third spacing
Provide oral iron and reassess in two hours
A 7-year-old arrives wheezing with hives and hypotension after peanut exposure. What is the first nursing action?
Deliver IM epinephrine in the thigh and place supine with legs elevated
Administer IV antihistamine and monitor for clinical response
Begin nebulized albuterol and reassess after two treatments
Obtain IV access and delay medications until access is secured
A 6-hour newborn after 22 hours of ruptured membranes and maternal fever is grunting with RR 72 and mottling. What is the priority?
Obtain cultures, start IV broad antibiotics, support airway and glucose
Await CRP results and begin therapy only if positive
Discharge with oral amoxicillin and next-day follow-up
Place prone and perform chest physiotherapy for comfort
A 9-month infant with bronchiolitis has SpO₂ 89% and intercostal retractions with poor feeds. What is the best immediate step?
Suction nares gently, provide oxygen to ≥90-92%, and support hydration
Schedule albuterol and amoxicillin for 48 hours
Give codeine syrup to suppress the cough reflex
Place prone and apply vibration to the posterior chest
A 3-year-old is febrile, drooling, tripod, and speaking with a muffled voice. What is the safest first step?
Keep the child calm upright, avoid oral exam, call airway team, provide blow-by oxygen
Use a tongue depressor to visualize the oropharynx in triage
Lay supine for lateral neck film before any intervention
Start IV dexamethasone and reassess before airway support
A near-drowning child is warm, alert, and normoxic 30 minutes after rescue. What is the best plan today?
Observe for several hours with continuous pulse-oximetry and serial assessments
Discharge immediately with routine return precautions
Start broad antibiotics and bed rest in the ward
Restrict fluids and begin early hallway ambulation
A 10-year-old with type 1 diabetes presents in DKA with Kussmaul respirations. Which initial steps are appropriate? Select all that apply.
Give an isotonic fluid bolus 10-20 mL/kg and send baseline labs
Start insulin infusion after fluids and after potassium assessment
Give an IV insulin bolus prior to rehydration
Perform frequent neurologic checks to detect cerebral edema
Administer IV bicarbonate routinely to normalize pH
A toddler has intermittent colicky pain, bilious emesis, and one 'currant-jelly' stool. What should the nurse do now?
Start laxatives and apply warm abdominal compresses
Keep NPO, secure IV access, provide analgesia, and prepare for air/contrast enema
Give oral barium at bedside for confirmation
Discharge with instructions to return if pain persists
A child with moderate croup has stridor at rest and sternal retractions. What are the immediate priorities? Select all that apply.
Administer nebulized epinephrine and observe for rebound
Give dexamethasone via oral, IV, or IM route as available
Minimize agitation and provide humidified oxygen as needed
Obtain a throat swab using a tongue blade in triage
Perform chest percussion and vibration for secretion clearance
A 6-week infant has projectile non-bilious emesis with visible peristalsis and a palpable RUQ 'olive.' What is the pre-operative priority?
Begin ad-lib oral feeds to test tolerance
Correct dehydration and electrolyte derangements prior to surgery
Start IV bicarbonate to reverse the metabolic alkalosis
Delay surgery until the infant's weight improves
A 12-kg child with watery diarrhea is thirsty, restless, and has delayed skin recoil - moderate dehydration. Which ORS-based actions are correct? Select all that apply.
Provide ~75 mL/kg ORS over about four hours with frequent reassessment
Continue breastfeeding and resume normal diet after rehydration
Replace ongoing losses with measured ORS after each stool or emesis
Use loperamide to reduce stool frequency routinely
Start IV fluids for all moderate cases regardless of response
After two back-to-back albuterol treatments, an 8-year-old in severe asthma speaks in single words with SpO₂ 89%. What is the best next step?
Stop oxygen to limit carbon dioxide retention
Add inhaled ipratropium, administer systemic corticosteroid now, titrate oxygen, consider continuous albuterol and IV magnesium
Give codeine to reduce cough and promote rest
Trial a nonselective beta-blocker to slow the heart rate
A 6-week-old infant has a temperature of 38.6 °C, is irritable but arousable, and has no source on exam. What is the best ED plan?
Perform a full sepsis evaluation, obtain cultures, and start empiric IV antibiotics
Give acetaminophen and discharge with routine precautions
Obtain a chest radiograph only and avoid lab work
Observe for 24 hours to see whether a rash develops
Parents of a 2-month-old ask how to reduce SIDS risk. Which counseling points are correct? Select all that apply.
Place supine on a firm, flat sleep surface for every sleep
Room-share without bed-sharing during the early months
Keep the sleep area free of soft bedding, pillows, and toys
Use prone naps if a caregiver is present to supervise
Avoid smoke exposure and keep immunizations up to date
A 14-month-old likely swallowed a button battery one hour ago and is drooling and refusing to swallow. What is the priority?
Give milk at triage and observe for passage at home
Induce emesis immediately to remove the battery
Keep NPO, obtain urgent radiographs from nasopharynx to rectum, and arrange emergent endoscopic removal if esophageal
Administer laxatives to accelerate intestinal transit
A child with nephrotic syndrome has generalized edema and albumin 2.0 g/dL with normal blood pressure. What should the nursing plan emphasize today?
Provide high-salt snacks to encourage diuresis
Record daily weight and strict I&O, protect the skin, use moderate sodium restriction, and administer ordered therapies
Institute universal fluid restriction regardless of status
Defer all immunizations indefinitely during childhood
A home visit reveals a non-ambulatory infant with a spiral femur fracture and bruises in different stages of healing. Which actions are mandated now? Select all that apply.
Report immediately to child protective services as required by law
Ensure the infant's safety and document objective findings
Confront the caregiver to obtain a confession on video
Arrange prompt medical evaluation and skeletal survey
Delay reporting until a consistent history is obtained
An 8-year-old with cystic fibrosis is admitted with increased cough and sputum. Which plan is best today?
Cluster all airway care after meals to promote rest
Schedule airway clearance before meals and at bedtime; give bronchodilator then mucolytics; ensure pancreatic enzymes and high-calorie, high-salt intake
Restrict salt to reduce secretions and thirst
Place on droplet isolation universally for all organisms
A 10-year-old with sickle cell vaso-occlusive crisis reports severe limb pain and has tachycardia but SpO₂ 97%. Which nursing actions are priorities? Select all that apply.
Initiate weight-based IV opioid analgesia with timely reassessment
Begin aggressive IV hydration and maintain warmth
Apply ice packs to numb the painful areas
Assess for infection triggers and provide supportive care
Delay analgesia until diagnostic imaging is complete
A 9-year-old with RLQ pain, fever, and anorexia is diagnosed with appendicitis and is awaiting surgery. What is the most appropriate nursing action pre-op?
Encourage a heating pad over the area for relief
Keep NPO, maintain IV fluids, provide analgesia, and monitor for perforation
Administer laxatives to decompress the bowel before surgery
Allow a light meal for energy and comfort
A 10-year-old with persistent asthma receives a new written action plan. Which teaching is most accurate?
Use short-acting beta-agonist daily for baseline control
Use a spacer, rinse after inhaled corticosteroid, pre-treat before exercise, and know peak-flow zones
Store the rescue inhaler at school in a locked office
Avoid vaccines during high-dose inhaled steroid therapy
A 4-year-old had a 3-minute generalized seizure with fever 39.5 °C and is now back to baseline. What is the best discharge teaching?
Start daily anticonvulsants to prevent recurrences
Explain that simple febrile seizures are usually benign; teach seizure first aid and return precautions
Order routine head CT to rule out structural lesions
Prohibit routine vaccinations for the next year
A teen presents with fever, petechial rash, hypotension, and confusion - suspected meningococcemia. What are the immediate nursing actions? Select all that apply.
Initiate droplet precautions without delay
Obtain cultures if possible and start IV broad antibiotics promptly
Begin aggressive fluids and vasopressors per protocol
Observe 24 hours before starting antimicrobial
A 3-day-old has weak femoral pulses, an upper-lower extremity BP gradient, and differential cyanosis. What is the most appropriate action?
Begin vigorous feeds to improve weight gain
Obtain four-limb blood pressures and pre/post-ductal saturations; notify cardiology for suspected coarctation
Apply tight swaddling and reassess in one week
Start high-dose furosemide immediately at bedside
A 5-year-old with type 1 diabetes has vomiting from gastroenteritis. Which sick-day instruction is best?
Hold all insulin until the child resumes normal eating
Continue basal insulin, check glucose and ketones regularly, give carbohydrate fluids, and follow correction dosing
Avoid carbohydrates to hasten ketone clearance
Double physical activity to normalize sugars
A 20-kg child sustained 20% TBSA partial-thickness burns 60 minutes ago. What is the priority in the first hours?
Start LR using Parkland formula, target urine ≥1 mL/kg/hr, provide warmth, analgesia, and tetanus update
Encourage oral water and delay IVs for comfort
Apply topical butter and cover with towels tightly
Restrict analgesia to avoid masking worsening pain
A 6-year-old in status epilepticus is actively seizing on arrival. What is the first nursing action?
Ensure airway and give a weight-based benzodiazepine promptly
Start a loading dose of fosphenytoin before any other drug
Insert a tongue blade to prevent biting during the seizure
Apply physical restraints and wait for the provider to arrive
A 12-year-old has sudden unilateral testicular pain, high-riding testis, and nausea for 90 minutes. What is the priority?
Place warm packs and reassess in two hours
Alert urology emergently, keep NPO, and prepare for urgent detorsion
Obtain a urine culture before any further steps
Schedule an outpatient ultrasound for the next morning
A 7-year-old has trismus, muffled voice, uvular deviation, and unilateral peritonsillar swelling. What is the best nursing action now?
Perform vigorous throat swabbing to confirm streptococcus
Maintain airway readiness, keep NPO, and notify ENT for drainage
Encourage large oral fluids to clear secretions quickly
Start deep oropharyngeal suctioning to remove exudate
An obese 12-year-old presents with limp and externally rotated foot; hip pain worsens with activity. Which immediate nursing steps are appropriate? Select all that apply.
Make the child non-weight-bearing and provide a wheelchair
Notify orthopedics urgently for suspected SCFE
Begin hip range-of-motion stretching at bedside
Provide analgesia and prepare for imaging without walking
Discharge with home exercises and sports when pain allows
A cyanotic term newborn remains hypoxic despite 100% oxygen; preductal and postductal saturations differ by 10%. What is the priority?
Feed small frequent volumes to reduce energy use
Notify the team to start prostaglandin E1 and prepare for transfer
Place prone with chest percussion to mobilize secretions
Give a trial of diuretic therapy to reduce pulmonary edema
A 3-year-old with severe dehydration is lethargic with cool extremities and delayed capillary refill. What is the first fluid action?
Start hypotonic saline at maintenance rates
Give isotonic crystalloid 20 mL/kg bolus and reassess
Begin oral rehydration solution in small frequent sips
Administer dextrose 10% as an initial rapid bolus
A child with palpable purpura, colicky abdominal pain, arthralgia, and hematuria is diagnosed with IgA vasculitis (HSP). Which nursing focus is most important today?
Monitor blood pressure and urine for protein and blood
Encourage NSAIDs around the clock for renal protection
Restrict fluids strictly to reduce edema formation
Promote vigorous activity to prevent joint stiffness
A student was hospitalized with meningococcal disease. Which contacts require chemoprophylaxis? Select all that apply.
Household members with frequent overnight exposure
Child-care classmates with close daily contact
Healthcare staff with direct airway secretion exposure
Casual schoolmates who sat across the classroom
Passing contacts at the grocery store last week
A 16-year-old with infectious mononucleosis asks about sports. What is the best guidance?
Resume all sports once afebrile for forty-eight hours
Avoid contact sports until splenic risk is cleared by exam or imaging
Return to full play after one week regardless of symptoms
Use a snug abdominal binder to protect the spleen in games
Amoxicillin is ordered 90 mg/kg/day divided twice daily for a 16-kg child using 400 mg/5 mL suspension. What volume per dose is correct?
6 mL
9 mL
10 mL
12 mL
A 5-year-old is diagnosed with tinea capitis. Which instructions are correct? Select all that apply.
Use oral antifungal therapy as prescribed for several weeks
Apply selenium sulfide or ketoconazole shampoo to reduce spread
Shave the scalp completely to speed resolution
Avoid sharing combs, hats, pillows, and hair accessories
Exclude from school until the scalp is completely clear
A 3-year-old with nonsevere acute otitis media is afebrile and comfortable. Parents ask about antibiotics. What is the best plan?
Start high-dose amoxicillin immediately for all ages
Offer watchful waiting with analgesia and close follow-up
Use topical anesthetic drops and no follow-up
Avoid all analgesics to allow diagnostic clarity
A 4-month-old with paroxysmal cough and posttussive cyanosis is suspected of pertussis. What is the priority nursing action?
Place in contact isolation and start steroids
Initiate droplet precautions and monitor for apnea events
Encourage large oral feeds to prevent weight loss
Give codeine cough syrup before any testing
A caregiver reports a possible acetaminophen overdose in a 4-year-old; time of ingestion is uncertain. Which steps are appropriate now? Select all that apply.
Obtain a serum acetaminophen level at or after 4 hours from ingestion
Draw baseline AST/ALT and assess co-ingestants
Consult poison control and prepare to start NAC if indicated
Give ipecac to induce emesis at home
Discharge without labs if the child is currently asymptomatic
A 13-year-old with type 1 diabetes is found unresponsive at practice; a glucometer shows 38 mg/dL. What is the best immediate action?
Administer glucagon and secure the airway; give oral carbohydrate once awake
Start a long run to raise circulating catecholamines
Place the child supine and wait for spontaneous recovery
Give a large soda by mouth while unconscious
Parents of a child with celiac disease ask about foods. Which guidance is best?
Avoid rice, corn, and potatoes because they contain gluten
Avoid wheat, barley, and rye; choose naturally gluten-free grains
Use oats freely regardless of processing source
Limit vaccines to reduce autoimmune activation
A school-age child with sickle cell disease develops new chest pain, fever, and hypoxia-suspected acute chest syndrome. Which actions are priorities? Select all that apply.
Administer oxygen and obtain chest imaging promptly
Start broad-spectrum antibiotics as ordered
Provide incentive spirometry and adequate analgesia
Restrict fluids strictly to prevent pulmonary edema
Delay blood transfusion discussions until discharge
A 9-year-old with refusal to bear weight, fever, and localized bone tenderness is suspected of osteomyelitis. What is the best nursing step?
Encourage walking to assess pain pattern more clearly
Obtain cultures, start IV antibiotics as ordered, and restrict weight-bearing
Give NSAIDs only and discharge with a splint
Begin deep tissue massage to reduce swelling
A 2-month-old with poor weight gain has hypernatremic dehydration; history reveals over-concentrated formula. What is the best teaching?
Mix formula exactly per label using safe water and precise measurement
Add cereal to bottles to raise calories quickly and safely
Give plain water between feeds to dilute sodium rapidly
Use honey as a natural thickener to improve intake
A 10-year-old demonstrates poor MDI-spacer technique. Which correction is best?
Inhale rapidly to push the drug deep into the lungs
Seal lips on mouthpiece, actuate once, inhale slowly and deeply, hold 10 seconds
Actuate three times and then take a single long inhalation
Skip the spacer to reduce device resistance during use
A child with DKA develops headache and bradycardia during treatment. What is the priority nursing action?
Increase insulin rate to hasten acidosis correction
Notify the provider immediately and prepare hyperosmolar therapy per protocol
Start rapid free water infusion to normalize osmolality
Place ice packs on the head to reduce discomfort
A 7-year-old with unknown records needs catch-up immunization. Which vaccines are appropriate today if no contraindications? Select all that apply.
Tdap as first tetanus-diphtheria-pertussis dose at this age
IPV series according to catch-up intervals
MMR
An adolescent with EBV mononucleosis asks about home care. Which advice is most accurate?
Rest, hydrate, use analgesics, and avoid contact sports until the spleen is cleared
Start amoxicillin immediately to shorten the illness duration
Begin strenuous exercise to prevent deconditioning
Use aspirin daily to reduce fever and throat pain
A 6-year-old receives IV morphine for severe pain. Which assessment is the priority after administration?
Respiratory rate and sedation level using a validated scale
Bowel sounds and daily stool frequency
Blood pressure trend and capillary refill
Oral intake volume and urine color
A preterm infant on feeds develops abdominal distension, emesis, and heme-positive stools; x-ray shows pneumatosis intestinalis. What is the priority nursing action?
Continue feeds slowly to maintain gut motility
Stop feeds, place OG for decompression, start IV fluids and antibiotics, and monitor closely
Give loperamide to reduce stooling frequency
Apply abdominal heat and reassess after thirty minutes
