# The mother of an 8-year-old with influenza A and a fever of 39.4°C asks the nurse if she can give her child aspirin for fever and body aches. Which response by the nurse is most appropriate? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=375138&lang=en > language: en > subject: Medical Emergencies > category: PA ## Question The mother of an 8-year-old with influenza A and a fever of 39.4°C asks the nurse if she can give her child aspirin for fever and body aches. Which response by the nurse is most appropriate? ## Option 1. You may give aspirin for fever in this case as long as you use the weight-appropriate pediatric dose, which is typically one-quarter of the adult dose, and you avoid giving it for more than three days; however, watch for signs of Reye syndrome like persistent vomiting or confusion. 2. Aspirin should not be given to children or adolescents under 19 with viral illness because of the risk of Reye syndrome; use weight-based acetaminophen or ibuprofen instead and report decreased alertness, persistent vomiting, irritability, or seizures immediately. **✔ Correct answer** 3. Aspirin acts more rapidly than acetaminophen to bring down fever, so for an 8-year-old with a temperature of 39.4°C, it is an appropriate choice if you use the recommended pediatric dose and have the child take it with a full glass of water to minimize gastric irritation. 4. Combining aspirin and acetaminophen by alternating them every 3 to 4 hours is a proven strategy for managing high fever in children with influenza, as it provides more consistent temperature control; start with aspirin and then give acetaminophen 4 hours later, and continue this pattern while monitoring for any signs of discomfort. **Correct answer: 2** ## Explanation Reye syndrome is a rare but life-threatening encephalopathy with fatty liver degeneration that follows viral illness in children given salicylates (aspirin, bismuth subsalicylate). The typical sequence is influenza or varicella, fever, and aspirin use, then 3 to 5 days later sudden persistent vomiting, lethargy, irritability, confusion, seizures, and coma. Mortality is high and survivors may have neurologic sequelae. The CDC, FDA, AAP, and American Heart Association all recommend avoiding aspirin and aspirin-containing products in children and adolescents under 19 years with confirmed or suspected viral illness, particularly influenza and varicella. Safer choices for fever and pain in this age group are weight-based acetaminophen (10 to 15 mg/kg every 4 to 6 hours, max 75 mg/kg/day not to exceed adult ceiling) or ibuprofen for older infants (5 to 10 mg/kg every 6 to 8 hours, with food, only in children over 6 months and not in dehydrated children). Bismuth subsalicylate (Pepto-Bismol) should also be avoided because it converts to salicylate. Teaching: always read child OTC labels for hidden salicylates, watch for warning signs (persistent vomiting, lethargy, behavior change, seizures), seek emergency care for those signs. ## In-depth explanation No aspirin under 19 with viral illness — Reye syndrome is the classic NCLEX answer. 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Always follow current clinical guidelines and your institution’s protocols._