What are the nursing priorities when a fever with dehydration is present?

• A. Administer antibiotics, restrict fluids, perform daily weights, immobilize patient
• B. Monitor vitals, ensure adequate fluids, maintain electrolyte balance, administer antipyretics as ordered
• C. Elevate legs, apply cold pack to forehead, keep NPO, administer IV fluids only if ordered
• D. Document fever and dehydration without action

Answer: (B)

Fever with dehydration raises the risk of fluid and electrolyte imbalances and increased metabolic demand, so the priorities are to monitor status, restore fluids, maintain electrolyte balance, and reduce fever to ease the body's strain. Monitoring vitals helps detect instability or fever spikes; ensuring adequate fluids (oral or IV as appropriate) reestablishes circulating volume and prevents further dehydration; maintaining electrolyte balance prevents complications like electrolyte shifts; administering antipyretics as ordered reduces fever, lowers metabolic demand, and improves comfort. Together these actions address both hydration and fever management.

Other options miss key needs: antibiotics aren’t indicated by dehydration alone, and restricting fluids worsens dehydration; unnecessary immobilization or sole daily weights don’t address the immediate fluid and fever care; keeping the patient NPO or delaying fluids unless specifically ordered isn’t appropriate when dehydration is present. Documenting alone without taking action also fails to protect the patient.