Final answer:
The correct option is c) assess for signs of dehydration. The nurse should first assess the child for signs of dehydration because puffiness around the eyes after strep throat could indicate complications like acute glomerulonephritis. It's critical to rule out serious conditions before considering more routine care or specialist referrals.
Step-by-step explanation:
Based on the clinical scenario of an 8-year-old girl with a recent history of strep throat now presenting with malaise, lethargy, and puffiness around the eyes, the first action the nurse should take is c) assess for signs of dehydration. Puffy eyes can be a sign of fluid retention, which, along the general malaise and lethargy could indicate complications such as acute glomerulonephritis, a potential post-streptococcal condition. It is essential to evaluate for any associated symptoms such as edema, changes in urine output, or blood pressure alterations. If any signs of acute glomerulonephritis or other complications are found, immediate medical intervention is required.
While administering fever-reducing medication or recommending bed rest and fluids are supportive measures, they do not address the potential seriousness of the situation. Referral to an ophthalmologist would generally not be the first action unless specific eye-related issues are of primary concern once acute conditions have been ruled out or treated. Understanding the relationship between streptococcal infection and potential renal complications is crucial when evaluating a recent strep throat patient showing signs of illness.