Final answer:
The nurse should see Child D first, the one with type 1 diabetes and a blood glucose level of 320 mg/dL, due to the urgency and potential severity of hyperglycemia. Next, the nurse can address the other children, starting with Child B who has pneumonia.
Step-by-step explanation:
When deciding which child the nurse should see first, it is crucial to prioritize care based on the severity and urgency of the condition. In this scenario, the nurse should evaluate the children using a systematic approach, focusing on immediate threats to life or the potential for rapid deterioration.
Child A, with a temperature of 99.8°F (37.7°C) and mild abdominal pain, might be uncomfortable but is not in immediate danger. Child B, diagnosed with pneumonia and having a respiratory rate of 28 breaths per minute, is slightly above the normal range but not critically high. Child C, who has a fractured arm and is requesting pain medication, has a non-life-threatening condition, although they need attention to manage pain. Lastly, Child D, with type 1 diabetes and a blood glucose level of 320 mg/dL, is experiencing hyperglycemia which could lead to diabetic ketoacidosis, a serious and possibly life-threatening condition if not treated promptly.
Based on the assessment, the nurse should prioritize and see Child D first. Hyperglycemia in type 1 diabetes needs immediate intervention to prevent complications such as diabetic ketoacidosis. After attending to Child D, the nurse can then evaluate the other children in order of urgency, likely following with Child B, as respiratory complications from pneumonia can escalate quickly.