A nurse is administering Pepto-Bismol to a 10-year-old with Reye's syndrome; priority action?

A nurse is administering Pepto-Bismol to a 10-year-old with Reye's syndrome; priority action?

• A. Administer the prescribed dose of 1 tablet
• B. Inform the child and parents that stools will be dark in appearance
• C. Instruct the child to chew the tablet thoroughly
• D. Question the physician's order

Answer: (D)

Giving salicylates to a child with Reye’s syndrome is dangerous. Pepto-Bismol uses bismuth subsalicylate, a salicylate, and salicylates are contraindicated in Reye’s syndrome because they can worsen brain and liver injury. The priority is to question the physician’s order and withhold the medication until you confirm a safe plan with the provider. If fever or discomfort needs management, switch to a physician-approved alternative such as acetaminophen after confirmation. The other actions don’t address the safety issue and could continue exposing the child to harm.

Giving salicylates to a child with Reye’s syndrome is dangerous. Pepto-Bismol uses bismuth subsalicylate, a salicylate, and salicylates are contraindicated in Reye’s syndrome because they can worsen brain and liver injury. The priority is to question the physician’s order and withhold the medication until you confirm a safe plan with the provider. If fever or discomfort needs management, switch to a physician-approved alternative such as acetaminophen after confirmation. The other actions don’t address the safety issue and could continue exposing the child to harm.