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ScenarioA 5-year-old Gabriel is a multiracial male weighing 48 lbs with an allergy to penicillin arrives in the emergency room, no cultural considerations identified. You are handed the following notes on the patient that read:He arrived in ER with his mother after falling out of bed after jerking movement activity as witnessed by his older brother while sleeping. Right-upper extremity appears with deformity. Mother and child speak English. Child has no significant medical history. Mother reports incontinent of urine during episode.Your AssessmentVital Signs: T 102.9, P 135, R 24, BP 118/60, O2 sat 100% RAGeneral Appearance: appears drowsy; face flushed, quietNeuro: oriented X3Cardiovascular: unremarkableRespiratory: lungs clearIntegumentary: very warm, dryGI/GU: abdomen normalPhysician OrdersComplete Blood Count (CBC)Complete Metabolic Panel (CMP)Urinalysis with culture and sensitivity (U/A C&S)Blood Cultures x 2X-rays kidneys,Influenza screeningAcetaminophen 15 mg/kg PO nowIbuprofen 10 mg/kg PO nowPad side railsSuction at bedside with seizure precautionsRadiographs of right armCast to right armStart PO fluids and increase as toleratedThe physician discharges Gabriel from ER to home with a diagnosis of; Right ear infection, Acute Febrile Seizure and fracture of the right ulna.Discharge orders include:Follow up with pediatrician in 7 daysFollow up with pediatric orthopedics in 7-10 daysCefuroxime 30mg/kg PO BID for 10 days not to exceed      1,000mg daily. What is the recommended dosage if cefuroxime is supplied as      an oral suspension 125mg/5ml or 250/5ml?Acetaminophen 15 mg/kg PO Q4 hours PRN      fever or pain and ibuprofen 10 mg/kg PO Q6 hours PRN fever and pain for up      to 3 daysAcetaminophen is available as 160 mg/5 mL.      Ibuprofen is available as 100 mg/ 5 mL.What is the amount of acetaminophen in mg      and ml per dose? What is the amount of ibuprofen in mg and ml per dose?InstructionsDevelop a discharge plan with three goals listed in order of priority (must be detailed and prioritization explained in depth) , prior to discharge from current orders. Provide rationale for why you listed the goals in a particular order. Also, list three detailed nursing interventions to meet each of the goals (you should have nine interventions in total). Last, give the mother the exact dosage she will need to give the child for acetaminophen, ibuprofen, and the cefuroxime when she gets home and explain why the exact dosage is important.

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