Chp 42 - Nursing Care of a Family When a Child Has an Immune Disorder

A nurse is explaining the immunotherapy regimen to the mother of a child with multiple allergies. During the teaching session, the mother asks, "Why do we need to stay in the clinic for a half-hour after the shot?" Which response by the nurse would be best?

"We can act quickly if your child has a reaction to the injection."

The nurse is teaching the parents of a 4-year-old client with a peanut allergy about dietary restrictions. Which response by the parents indicates a need for further teaching?

"We cannot go wrong with barbeque and french fries."

The nurse is caring for a child who weighs 44 lb (20 kg) experiencing an anaphylactic reaction. The health care provider has prescribed an epinephrine 0.01 mg/kg injection. Epinephrine is supplied at 1 mg in 10 ml. How many milliliters will the nurse administer? Record your answer using a whole number.

2 mL

A 9-year-old child is sent to the school nurse because the child states not feeling well and being bothered by allergies. The child appears to have dark circles under the eyes with watery nasal secretions and pale nasal mucosa. Which nursing action(s) will be completed in the school's health office? SATA

> Assess current allergens in the child's environment. > Assess the inner ear and tympanic membrane. > Allow child to rest for 30 minutes before returning to class. · Assist with gargling of a salt water solution. · Call the parent and send the child home.

The nurse is caring for an infant who exhibits characteristics of allergies. Which suggestion(s) for the parents are helpful in minimizing allergy development? SATA

> Discontinue cigarette smoking. > Keep the room dust-free. > Use laundry detergent that has as few chemicals as possible. > Avoid perfumes and room fresheners.

Which client will the nurse assess first after receiving shift report?

A client with human immunodeficiency virus (HIV) whose temperature is 102.2°F (39°C)

The parents of a 3-month-old infant report concerns the infant is irritable, feeds poorly, and has a rash. The nurse notes weeping, crusty lesions on the infant's cheeks and neck. Which action by the nurse is most appropriate?

Contact the health care provider to request treatment.

The school nurse is walking through the lunchroom when one of the children says she started to feel strange after trading lunches with a friend. Which assessment would be most important?

Determining if her throat itches

The nurse is assisting with skin testing on a pediatric client with allergies. What will the nurse do first?

Ensure the child has not taken diphenhydramine in the past week.

A nurse is preparing a plan of care for a child with a primary immunodeficiency. Which nursing diagnosis is the priority?

Ineffective protection related to impaired humoral defenses

Which nursing action is most appropriate when caring for a child with positive serum IgE antibodies, a white blood cell count of 6,000/mm3, and 10% eosinophils?

Obtain a careful health history.

The nurse is caring for a child undergoing highly active antiretroviral therapy (HAART) for HIV infection. The nurse is preparing to administer the prescribed medication. In addition to the nucleoside analog reverse transcriptase inhibitors (NRTIs) and the nonnucleoside analog reverse transcriptase inhibitors (NNRTIs), the nurse is cognizant that the child will be taking which additional medication as part of the three-drug regimen?

Protease inhibitors

The nurse is instructing a group of women of childbearing age about human immunodeficiency virus (HIV) during pregnancy. What would be a priority recommendation in this setting?

Screening for HIV

After teaching an adolescent how to use an epinephrine autoinjector, the nurse observes the adolescent attempting to self-administer the medication. The adolescent indicates the site to be used, pointing to the abdomen just below the umbilicus. Which action should the nurse take next?

Stop the adolescent from continuing and review the appropriate site to use.

The nurse is providing care to a child with a latex allergy. The nurse notifies all care providers of the allergy and assesses for which early sign of an anaphylactic reaction?

Vomiting

A client presents to the clinic for allergy testing. The nurse is reviewing current medications taken within the past 5 to 7 days. Which classification of medication, if taken by the client, will cause the nurse to reschedule the allergy testing appointment?

antihistamine

The nurse is explaining to a parent some of the basic aspects of the immune system and its functions. She informs them that B cells, also known as _________ cells, will attack __________ antigens.

humoral; bacterial

A mother who is HIV positive is distraught when she learns that her 6-month-old baby is also HIV-positive. The child had undergone open heart surgery as a newborn and had received numerous blood transfusions. The nurse recognizes that the most likely means of transmission of the disease to this child was:

placental spread during pregnancy.

A pediatric client is admitted to the hospital. The primary health care provider suspects a problem with the child's immune system. The nurse anticipates preparing this client for which test initially?

serum blood testing

A nurse is preparing a presentation for a group of new parents and is planning to discuss nutrition during the first year. As part of the presentation, the nurse is planning to address foods that should be avoided to reduce the risk of possible food allergies. Which foods would the nurse most likely include? Select all that apply.

> Eggs > Shrimp > Peanuts · Carrots · Potatoes · Bananas

The nurse is caring for a child who is having bronchospasm. The nurse would expect to administer what medication?

albuterol

Which nursing diagnosis will the nurse select as appropriate for the child with atopic dermatitis? SATA

> Impaired skin integrity related to skin barrier function Delayed growth related to chronicity of immune disorder Ineffective breathing pattern related to allergic bronchospasm > Anxiety related to continuing or uncontrolled allergic response > Powerlessness related to difficulty determining a cause of allergy

A 9-month-old infant presents with a rash on the face and extensor surfaces and signs of secondary infection on the face. The infant is irritable and not sleeping well. The nurse suspects infantile eczema (atopic dermatitis) and provides which teaching point(s)? SATA

. Keep clothing snug on your infant's body to prevent clothing movement against the rash. . Environmental allergies are the most common cause; check your infant's surroundings for latex. > It is important we perform allergen testing to identify the source of the dermatitis. > Has anyone in your family had this problem? It often runs in families. > A good time to apply lubricants to the affected areas is after a bath.