Questions: A child admitted to the hospital for meningitis suddenly reports stomach cramps, anorexia, and vomiting. The nurse finds the child to be irritable with altered consciousness. The child's serum sodium levels are found to be 120 mEq / L. Which would be the most appropriate immediate next step of the nurse? - Restrict oral fluids. - Give intravenous fluids. - Restrict sodium consumption. - Administer analgesic and antiemetic drugs.

The answer is the second one: Give intravenous fluids.

Explanation for each option:

1. Restrict oral fluids: This would not be appropriate because the child is showing signs of hyponatremia (low sodium levels), which can be life-threatening. Restricting fluids could worsen the condition.

2. Give intravenous fluids: This is the correct answer. The child has a serum sodium level of 120 mEq/L, which is significantly lower than the normal range (135-145 mEq/L). This condition, known as hyponatremia, can cause symptoms such as irritability, altered consciousness, stomach cramps, anorexia, and vomiting. Immediate administration of intravenous fluids, typically hypertonic saline, is necessary to correct the sodium imbalance and prevent further complications.

3. Restrict sodium consumption: This would be inappropriate because the child already has low sodium levels. Restricting sodium intake would exacerbate the hyponatremia.

4. Administer analgesic and antiemetic drugs: While these medications might help with symptoms like pain and vomiting, they do not address the underlying issue of severe hyponatremia. Immediate correction of the sodium imbalance is the priority.

Summary: The most appropriate immediate next step for the nurse is to give intravenous fluids to correct the child's severe hyponatremia and prevent further complications.