PEDI CHPT 25

The nurse is caring for a 6-month-old infant with Wiskott-Aldrich syndrome. Which teaching does the nurse provide the parent? "Do not use a tub bath for daily cleansing." "Do not insert anything in the rectum." "Do not encourage a pacifier due to possible oral malformation." "Do not use a sponge bath for light cleaning."

"Do not insert anything in the rectum" Children with Wiskott-Aldrich syndrome should not be given rectal suppositories or temperatures since these children are at a high risk for bleeding. Tub baths are not contraindicated. Pacifi ers are not contraindicated in Wiskott-Aldrich but should be kept as sanitary as possible to avoid oral infections.

The parent of a school-age child comments to the nurse, "Every time my child eats enchiladas at our local Mexican restaurant the child gets a rash. It just does not make sense to me." How should the nurse respond? "Maybe it is an allergy to something else and you just notice after eating there by coincidence." "Is your child allergic to milk?" "Has your child ever been tested for a peanut allergy?" "That is odd. Does anyone else in your family react that way?"

"Has your child ever been tested for a peanut allergy?" Enchilada sauce is an unexpected food that may contain a form of peanuts (such as peanut oil) that may be causing an allergic reaction in the child.

The nurse is administering nevirapine to an adolescent client diagnosed with HIV. The client asks the nurse how this medication helps fight HIV. How should the nurse respond? "This medication prevents infection from occurring in your body." "This medication is an anti-inflammatory drug that will help you feel better." "The medication disrupts the virus life cycle of HIV. This prevents the disease from progressing." "This medication boosts your immune system so you don't get infections."

"The medication disrupts the virus life cycle of HIV. This prevents the disease from progressing." Nevirapine is a nonnucleoside analog reverse transcriptase inhibitor (NNRTIs) that binds to HIV-1 reverse transcriptase, blocking DNA polymerase activity and disrupting the virus life cycle. It's used for treatment of HIV-1 infection as part of a three-drug regimen.

The nurse is monitoring the CD4 count of an infant who has contracted HIV from the mother in utero. The nurse is concerned that treatment with antiretroviral therapy is not effective when noting which CD4 level? 1900/mm3 1300/mm3 1700/mm3 1500/mm3

1300/mm3 The number of CD4 T lymphocytes in the blood helps to determine the effectiveness of antiretroviral therapy. Normal is 1500/mm3 in the infant, so anything below that number may indicate that the therapy is not effective.

The nurse is assessing a child who is experiencing renal complications as a result of lupus. Which finding is of greatest concern? elevated blood pressure hypotension reduced body temperature elevated temperature

Elevated blood pressure Renal complications may result from lupus. This may be accompanied by hypertension making monitoring of blood pressure of the highest importance.

When describing anaphylaxis to a group of parents whose children have experienced anaphylaxis from insect stings, the nurse integrates knowledge that this response is related to which immunoglobulin? IgA IgE IgG IgM

IgE Anaphylaxis is an acute IgE-mediated response to an allergen that involves many organ systems and may be life-threatening

The nurse is discussing food allergies with parents of a young child, explaining that a very effective way to determine which foods a child may be allergic to is to implement: allergy skin testing. an elimination diet. a raw food diet. a food diary.

an elimination diet. The food diary may identify foods the child does not tolerate well, but it lacks the objectivity of the elimination diet. Skin testing usually involves whole proteins and will not test for reactions to food breakdown products. A raw food diet does not apply to allergy identification.

A child with a known allergy to bees is stung while on the playground at school. The school nurse is the first to arrive and notes the child is wheezing and begins vomiting. What will the nurse do first? Give an antihistamine. Administer epinephrine. Call an ambulance. Apply ice to the sting.

Administer epinephrine. The nurse's first action when a child is experiencing an allergic reaction is to administer epinephrine to reverse the effects. After administering epinephrine, the nurse should call an ambulance, apply ice, and administer an antihistamine, such as diphenhydramine.

The nurse is caring for a school-age child recently diagnosed with an allergy to peanuts. Which nursing action is a priority? Include the child when discussing foods that contain peanuts. Advise parents the child may benefit from skin testing. Remind parents to report the allergy to the child's school teacher. Offer the parents information about a community support group.

Include the child when discussing foods that contain peanuts. Involving school-age children in education related to their allergy helps them play an active role in their own care. Involving the child in teaching also helps to plan nursing care that meets QSEN competencies and also best meets the family's needs. Although advising parents the child may benefit from skin testing of other allergies, informing the child's school of the peanut allergy, and offering information about community support groups are important, involving the child in education is the best method to prevent exposure to the allergen.

A nurse is providing care to a child with HIV who is prescribed therapy with a nucleoside reverse transcriptase inhibitor. What would the nurse expect to administer? Efavirenz Ritonavir Nevirapine Zidovudine

Zidovudine Zidovudine is a nucleoside reverse transcriptase inhibitor. Nevirapine and efavirenz are classified as nonnucleoside reverse transcriptase inhibitors. Ritonavir is a protease inhibitor

To avoid anaphylactic reactions in children, which question would be most important to ask a parent before administering penicillin to her infant? "Has she ever had penicillin before?" "Is there any family history of allergy to penicillin?" "What do you give her to alleviate itching?" "Do you have a telephone to call us immediately if she develops trouble breathing?"

"Has she ever had penicillin before?" Penicillin is a drug frequently involved in allergic reactions. The reaction occurs after the child has first been sensitized to the drug

The nursing instructor has completed a presentation on normal immune function. Which statement by a student would suggest a need for further education? "Humoral immunity is generally functional at birth." "Phagocytosis is the process in which phagocytes swallow up and break down microorganisms." "Cellular immunity is cell-mediated immunity controlled by T cells." "Humoral immunity is immunity mediated by antibodies secreted by B cells."

"Humoral immunity is generally functional at birth." Normal immune function is a complex process involving phagocytosis (process by which phagocytes swallow up and break down microorganisms), humoral immunity (immunity mediated by antibodies secreted by B cells), cellular immunity (cell-mediated immunity controlled by T cells), and activation of the complement system. Cellular immunity is generally functional at birth, and as the infant is exposed to various substances over time, humoral immunity develops.

The nurse is providing teaching about food substitutions when cooking for the child with an allergy to eggs. Which response indicates a need for further teaching? "1.5 Tbsp each of water and oil, plus 1 tsp baking powder, equals one egg in a recipe." "1 tsp yeast and ¼ cup warm water is a substitute in baked goods." "I must not feed my child eggs in any form." "I can use the egg white when baking, but not the yolk."

"I can use the egg white when baking, but not the yolk." The parents must understand that their child cannot consume any part of an egg in any form. The other statements are accurate.

The nurse is teaching the parents of a child with a suspected diagnosis of juvenile idiopathic arthritis about the disease. Which statement by the parents demonstrates the need for further teaching? "If our child does not have a positive rheumatoid factor, our child does not have the disease." "It is important to control our child's inflammation and pain." "Swimming is a good activity that will help our child maintain joint mobility." "A warm bath at bedtime and warm compresses can increase our child's comfort."

"If our child does not have a positive rheumatoid factor, our child does not have the disease." Unlike adult rheumatoid arthritis, few types of juvenile arthritis actually demonstrate a positive rheumatoid factor. Therapeutic management focuses on inflammation control, pain relief, promotion of remission, and maintenance of mobility. The parents can promote sleep and comfort with a warm bath at bedtime and warm compresses to affected joints or massage. Swimming is a particularly useful exercise to maintain joint mobility without placing pressure on the joints.

The nurse has completed an education session with parents of children diagnosed with food allergies. Which statement by a parent would indicate a need for additional education? "If we need to use the EpiPen® we will need to notify her physician's office the next business day." "I have found a website that makes medical alert bracelets in my daughter's favorite color." "I will make sure my daughter always has her EpiPen® with her all the time." "The grey part of the EpiPen® should never be removed until right before we use it."

"If we need to use the EpiPen® we will need to notify her physician's office the next business day." If an EpiPen® is used, the child still needs immediate medical attention. EpiPens should be carried with the patient at all times. When administering an EpiPen, the grey safety cap should not be removed until immediately prior to using. Medical alert bracelets or necklaces should be worn by all children with severe allergies

The parents of a 5-month-old infant diagnosed with humoral IgA deficiency question the nurse about why the infant was not diagnosed sooner. Which response by the nurse most appropriate? "This is associated with allergies, which may not be noted prior to 5 months." "IgA deficiency is usually found when evaluating for another illness." "There is no treatment or cure specific for IgA deficiency in children." "Maternal antibodies crossed the placenta and that prevented infections until now."

"Maternal antibodies crossed the placenta and that prevented infections until now. IgA deficiency does not have a specific treatment, is usually found when evaluating other illnesses, and is associated with allergies. However, the nurse's most appropriate response to the parents' question about why the infant was not diagnosed sooner is to explain how maternal antibodies prevent manifestation of the deficiency until the infant is approximately 4 months old.

The nurse is providing dietary interventions for a 12-year-old child with a shellfish allergy. Which response by the parent most concerns the nurse? "My child will likely outgrow this." "I am very upset about this diagnosis." "My child must avoid consuming lobster." "We will only eat at home and not dine out."

"My child will likely outgrow this." Older children and adolescents with allergic reactions to fish, shellfish, and nuts usually continue to have that concern as a life-long problem. The nurse wants to ensure the parent understands the severity of the allergy and does not expose the child as the child ages. Lobster should be avoided because it is a shellfish. The nurse needs to educate the parent that the child can dine in restaurants as long as questions are asked of meal contents and menus are read carefully. The nurse also needs to explore the parent's feelings; however, client safety is priority.

The nurse is speaking with a teenager who has requested HIV testing. Which is the best statement by the nurse regarding HIV testing? "The ELISA test is a single test. It does not require you to be tested multiple times." "Since you are a minor, this test is confidential." "Autoimmune disorders may cause you to have a false negative result on the ELISA test." "The ELISA method detects antibodies so a person may have a false negative test for up to six months after exposure.

"The ELISA method detects antibodies so a person may have a false negative test for up to six months after exposure." ELISA method detects only antibodies, so the test may remain negative for several weeks up to 6 months (false-negative) after exposure. A false-positive may result with autoimmune disease. The ELISA test requires serial testing. HIV test results are confidential.

A nurse is giving a talk to high school students about preventing the spread of human immunodeficiency virus (HIV). What does the nurse identify as ways in which HIV is spread? Select all that apply. Through breastfeeding Sharing contaminated needles Perinatally from mother to fetus Exposure to blood and body fluids through sexual contact Sharing the same bathroom Transfusion of contaminated blood

-Exposure to blood and body fluids through sexual contact -Sharing contaminated needles -Transfusion of contaminated blood -Perinatally from mother to fetus -Through breastfeeding HIV is spread by exposure to blood and other body fluids through sexual contact, sharing of contaminated needles for injection, transfusion of contaminated blood, perinatally from mother to fetus, and through breastfeeding. It cannot be contracted by using the same bathroom. It must be direct contact.

The nurse is caring for a young child with HIV. Which nursing intervention is priority for this child? Review laboratory CD4 counts daily. Assist the child with daily activities. Assess pain after invasive procedures. Administer prescribed medications.

Administer prescribed medications. Although assisting with activities, assessing pain, and reviewing CD4 counts are all important, the priority when caring for a child with HIV is to administer prescribed medications. Prescribed medications prevent progressive deterioration of the immune system and provide prophylaxis against opportunistic infections.

A school-aged child, who is allergic to bee stings, states, "I think I was stung by a bee outside." Which intervention by the school nurse is most appropriate? Apply an ice compress to the site Determine if the client was stung Assess the client for signs of anaphylactic shock Administer epinephrine

Assess the client for signs of anaphylactic shock First, the nurse will assess the client for signs of anaphylactic shock and then administer epinephrine if warranted. Epinephrine counteracts histamine release to decrease bronchospasm and difficulty breathing. If there were no signs of anaphylactic shock, the nurse would determine if the child was actually stung. The nurse would apply ice to promote vasoconstriction once the client was stable.

The nurse is providing teaching for the parents of a child with a latex allergy. The nurse tells the client to avoid which food? blueberries pumpkins pomegranates bananas

Bananas The nurse should instruct children and their families to avoid foods with a known cross-reactivity to latex, such as bananas

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? Advise the parents to change the infant's formula. Encourage parents to avoid feeding the infant peanuts. Instruct the parents to soak the lesions in mineral oil. Contact the health care provider to request treatment.

Contact the health care provider to request treatment. Infants that feed poorly, are irritable, and have a weeping, crusty rash on the checks and neck may have atopic dermatitis (infantile eczema). The nurse should contact the health care provider to request treatment, which may include methods to avoid allergens. Although reducing exposure to identified allergens is important, a 3-month-old infant should not be eating peanuts, so this information would not be appropriate at this time.

The nurse is caring for a child who is receiving an intravenous immunoglobulin treatment. The client calls the nurse and reports she vomited. What action should be completed first? Discontinue the infusion. Take the client's vital signs. Check the physician's orders for an antiemetic. Contact the physician.

Discontinue the infusion. Clients receiving intravenous immunoglobulin are at risk for anaphylaxis. Vomiting can signal an allergic response. The first action would be to stop the infusion. The remaining activities are appropriate for inclusion in the plan of care but are not of the highest priority

The nurse is helping the parents of a toddler identify foods that are causing allergic symptoms in the child. Which strategy should the nurse encourage the parents to use? Corticosteroid challenge testing Elimination diet Complete dietary protein restriction Hyposensitivity testing

Elimination diet An elimination diet is a traditional method to detect food allergens. Parents feed the child only foods that rarely cause allergy, such as rice, lamb, carrots, peas, and sweet potatoes, for about 7 days. Then they add, one by one, at 2- to 3-day intervals, foods that are suspected of causing allergy. When a food is introduced this way, the child must be encouraged to eat a lot of it that day. If symptoms occur, the food is then eliminated from the child's meals on a permanent basis. If no symptoms occur, the child can continue to eat the food. Hyposensitivity testing is unreliable with food allergies. Corticosteroids delay hypersensitivity reactions. It is difficult to totally eliminate protein from the diet, and this is not a method to determine the cause of food allergies in the toddler.

The nurse is monitoring the labs of a child admitted for an exacerbation of juvenile pauciarticular arthritis. Which lab result does the nurse expect to be elevated? lymphocyte immunophenotyping T-cell quantification erythrocyte sedimentation rate (ESR) immunoglobulin electrophoresis radioallergosorbent test

Erythrocyte sedimentation rate (ESR) The erythrocyte sedimentation rate (ESR) is an indicator of inflammation; it would likely be elevated during an exacerbation of arthritis. Immunoglobulin electrophoresis determines the level of individual immunoglobulins; it would not be elevated in an autoimmune disease. Lymphocyte immunophenotyping T-cell quantification measures T-cells; this would be used to monitor immunosuppressive disorders. The radioallergosorbent test measures minute quantities of IgE in the blood; it is used for asthma and food allergy testing.

The nurse is administering the prescribed intravenous immunoglobulin to a 10-year-old boy. What step would be most important for the nurse to do? Have epinephrine available. Monitor for signs of Cushing syndrome. Administer with food. Monitor urine for glucose.

Have epinephrine available. The nurse should have epinephrine available during the infusion in case of an adverse reaction. Monitoring urine for glucose would be appropriate when corticosteroids are being given. Intravenous immunoglobulin does not need to be administered with food because it is being given as an intravenous infusion. Monitoring for signs of Cushing syndrome would be appropriate when corticosteroids are given.

The nurse is providing education regarding 2030 Health Goals to reduce the incidence of acquired immunodeficiency syndrome (AIDS) within the community. Which goal will the nurse choose as a primary prevention strategy? Reduce the baseline level of allergens in dust within homes and buildings. Refer at-risk community members to the clinic for HIV/AIDS screening. Increase the number of schools with an indoor air management system. Provide education to sexually active females about proper condom usage.

Provide education to sexually active females about proper condom usage. Primary prevention strategies focus on preventing a disease before it occurs, which includes condom usage to prevent being exposed to AIDS. Screening for the presence of AIDS is a secondary prevention strategy because it does not prevent an individual from contracting AIDS, but would allow for early identification. Improving air quality and reducing allergens are goals to prevent allergies.

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? Prophylactic treatment for HIV Screening for HIV Proper nutrition Screening for sexually transmitted infections (STIs)

Screening for HIV No screening mandate has been put forth for HIV, but all pregnant women should be encouraged to undergo this test. Prophylactic treatment would be initiated only once the woman has been screened. Screening for STIs and ensuring proper nutrition are also part of health promotion for women in this age group, but they are of lower priority than identifying HIV-positive individuals

The nurse is explaining patterns of incidence and transmission of HIV to a group of adolescent girls. She explains that the risks for this population are much higher because of the possibility of both vertical and horizontal transmission. Horizontal transmission refers to transmission of the disease during: sexual contact. the birthing process. feeding with breast milk. pregnancy.

Sexual contact Horizontal transmission refers to person-to-person transfer of the virus. Transmission by feeding with breast milk, birthing, and pregnancy are all examples of vertical transmission

The registered nurse (RN) and unlicensed assistive personnel (UAP) are caring for a pediatric client with an immune disorder receiving a stem cell transplant. Which action by the UAP will cause the RN to intervene? The UAP wears a mask when entering the client's room. The UAP takes a rectal temperature on the client. The UAP assists the client to ambulate in the room. The UAP places a lunch tray in the client's room.

The UAP takes a rectal temperature on the client. Precautions must be taken to protect the client from infection. The RN would intervene if the UAP takes a rectal temperature because this increases the client's risk for infection. The client should not receive rectal suppositories as well. The RN would ensure meticulous oral care is provided and encourage appropriate and adequate nutrition. Delivering a meal tray, wearing a mask when entering the room, and assisting the client to ambulate in the room are all appropriate actions by the UAP.

The nurse is preparing a care plan for a 4-year-old client newly diagnosed with severe combined immune deficiency. What is the priority goal for this client? The client will demonstrate basic knowledge of the disorder. The client will remain free from infection. The client will perform hygiene care with assistance. The client will return to normal activities after discharge.

The client will remain free from infection. While all of these are goals for the client, the highest priority for the immunocompromised client is to remain free from infection since the client is at a high risk for development of an infection. In the immunocompromised client any infection can be life threatening. Performing hygiene care helps promote cleanliness and decrease infection rates. This age group can do some tasks, but still need assistance. The client is old enough to have a basic understanding of the disorder. The primary goal is focused on remaining infection free and not on activities after discharge at this time.

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? Headache Vomiting Difficulty breathing Evidence of a wheal or other skin reaction

Vomiting The GI system is the first to be overwhelmed by excessive histamine release.

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? "Some hot chocolate mixes have peanuts." "We cannot go wrong with barbeque and french fries." "Baked goods often contain hidden peanut ingredients." "We must be careful with Asian food."

We cannot go wrong with barbeque and french fries The nurse needs to remind the parents that peanut oil might be a hidden ingredient in barbecue sauce. Baked goods can be hidden sources for peanut oil and peanuts. Hot chocolate may contain peanuts or peanut oil. Asian foods may contain hidden peanuts.

The nurse is caring for a child with juvenile idiopathic arthritis (JIA). There is involvement of five or more small joints and it is affecting the body symmetrically. This tells the nurse that the child: has polyarticular JIA. has pauciarticular JIA. is at risk for anaphylaxis. has systemic JIA.

has polyarticular JIA Polyarticular JIA is defined by the involvement of five or more joints, frequently the small joints, and affects the body symmetrically. Pauciarticular JIA is defined by the involvement of four or fewer joints. Systemic JIA presents with fever and rash in addition to join involvement at the time of diagnosis. The child with JIA is not at greater risk for anaphylaxis.

A child with systemic lupus erythematosus is receiving hydroxychloroquine sulfate. Which instruction would the nurse emphasize when teaching the child and parents about this drug? importance of yearly eye examinations giving with foods to minimize gastrointestinal upset need to gradually taper the drug dosage over time avoiding grapefruit juice when taking the drug

importance of yearly eye examinations When hydroxychloroquine is given, the child should have a fundoscopic eye exam and visual field testing every year. Corticosteroids need to be tapered gradually over time. Cyclosporine A should not be taken with grapefruit juice. Nonsteroidal anti-inflammatory agents should be given with food to decrease gastrointestinal upset.

The nurse is caring for a child with HIV. The doctor will most likely order which test to monitor the child's progress? immunoglobulin electrophoresis lymphocyte immunophenotyping T-cell quantification IgG subclasses complement assay (C3 and C4)

lymphocyte immunophenotyping T-cell quantification Lymphocyte immunophenotyping T-cell quantification is for ongoing monitoring of progressive depletion of CD4 T lymphocytes in HIV disease. The nurse would expect the physician to order a complement assay (C3 and C4) for ongoing monitoring of systemic lupus erythematosus. IgG subclasses measure the levels of the four subclasses of IgG and are used to determine immunodeficiencies. Immunoglobulin electrophoresis is ordered for immunodeficiency and autoimmune disorders, not to monitor systemic lupus erythematosus.

The nurse is providing education to a 16-year-old who has recently been diagnosed with myasthenia gravis. Which statement(s) by the adolescent indicates an understanding of the information provided? Select all that apply. "I am going to incorporate a short nap into my daily routine." "It is important I avoid triggers." "It can take several months to cure this disease." "Attending public school will likely no longer be possible." "Getting a flu shot will be important."

"It is important I avoid triggers." "Getting a flu shot will be important." "I am going to incorporate a short nap into my daily routine." Myasthenia gravis is an autoimmune condition characterized by weakness and fatigue. Management involves avoiding triggers such as stress and illness. Taking a flu shot will aid in avoidance of influenza which can be dangerous for someone with this disease. Fatigue is a concern and rest periods should be incorporated in to the teens schedule. There is no cure for the condition. There will need to be modifications in the teen's normal routine but attending public schools is possible.

When providing discharge instructions to a child who was admitted to the hospital following stridor, wheezing, and urticaria after taking penicillin, which nursing action is priority? Question the child about the amount of penicillin that was taken. Advise the parents to have their child evaluated for atopic diseases. Educate the parents about possible side effects of penicillin in children. Encourage the child to wear a medical alert bracelet for penicillin.

Encourage the child to wear a medical alert bracelet for penicillin. Oral medications most likely to cause an allergic reaction include antibiotics, acetylsalicylic acid (aspirin), and NSAIDs. Children experiencing stridor, wheezing, and urticaria after taking a medication most likely have an allergy to that medication. The priority nursing action for discharge education is to prevent the child from being exposed to penicillin again, which could be accomplished by encouraging the child to wear a medical alert bracelet. Although children with atopic diseases are more likely to have medication allergies, requesting parents have the child evaluated is not a priority. Questioning the child about the amount of penicillin taken and educating parents about the side effects of penicillin is not a priority.

The parents of an adolescent tell the nurse, "Our child seems to have allergy symptoms every time we visit our favorite cafe. I don't understand since the only allergy indicated in the testing was to eggs?" How should the nurse respond? "Maybe the allergy testing didn't evaluate everything your child is allergic to." "Does your child get a whipped cream or foam topping on their favorite drink?" "That doesn't really make any sense if your child is only allergic to eggs." "Maybe coffee drinks just don't agree with your child's system."

"Does your child get a whipped cream or foam topping on their favorite drink?" Albumin, globulin, ovalbumin should be avoided if allergic to eggs. Some foam toppings for drinks contain these substances and would cause an allergic reaction to the person allergic to eggs. This would be important information to ascertain from the family as they would likely not be aware of this.

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) A client with contact dermatitis who has blisters and mild edema on the lower extremities A client newly diagnosed with allergic rhinitis prescribed loratadine 10 mg A client with serum sickness stating, "I just feel bad all over."

A client with human immunodeficiency virus (HIV) whose temperature is 102.2°F (39°C) Of the immunologic disorders, HIV infection is the most serious. This client is also exhibiting an unexpected manifestation, which could indicate an infection. The clients with serum sickness and dermatitis are exhibiting expected findings and would be seen last. The client newly diagnosed needs to be seen second to have the medication started and receive education.

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. Shrimp Peanuts Carrots Bananas Potatoes Eggs

Peanuts Eggs Shrimp Foods that should be avoided in children younger than 1 year of age include cow's milk, eggs, peanuts, tree nuts, sesame seeds, and fish and shellfish (i.e., shrimp). Carrots, potatoes, and bananas are not considered problematic.

The parents of a 10-year-old with HIV have never told their child that he has the virus. The child asks the nurse why he is "on so many medications." What action should the nurse take? The nurse should encourage the child to talk with his parents about his medications. The nurse should explain the infection to the child. The nurse should tell the parents when they enter the child's room that their child has a question for them. The nurse should suggest to the child to speak with his doctor.

The nurse should encourage the child to talk with his parents about his medications Generally, children older than 6 years of age will eventually need to have their diagnosis disclosed to them in an age-appropriate manner. They begin to ask questions and often seem to sense that something is going on other than what they've been told so far. Encouraging discussion with the parents is the best first step.

A 13-year-old female adolescent is being evaluated for lupus. Which statement(s) by the adolescent indicates a need for further education regarding this disease? Select all that apply. "My grandmother was diagnosed with lupus, so that means I am at a higher risk." "I just got over a sinus infection last week. This may have been what triggered the disease." "I should have not spent so much time in the sun. That may have been what caused me to get lupus." "I am at a higher risk than of developing lupus than a man would be." "Since I am 13, it would be unusual for me to be diagnosed. Younger kids usually get it."

-"Since I am 13, it would be unusual for me to be diagnosed. Younger kids usually get it." -"I should have not spent so much time in the sun. That may have been what caused me to get lupus. Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder that affects both humoral and cellular immunity. SLE can affect any organ system, so the onset and course of the disease are quite variable. There are some identified risk factors including female gender. Groups, such as those of African or Asian descent, have a higher incidence of lupus. Family history does have a role in this condition. A recent infection may be reported by some diagnosed with the condition. Lupus is typically diagnosed around the age of puberty.

A pediatric client is newly diagnosed with a stinging-insect allergy. Which advice is most appropriate for the nurse to provide this client's parent? "Obtain your child a medical alert ID bracelet so the presence of the allergy can be identified easily." "I recommend you consult a genetic counselor to reveal other susceptible family members." "Arrange for your child to receive allergy testing for foods with ingredients similar to those in insect venom." "Your child should join a peer support group to help relieve anxiety about this problem."

Obtain your child a medical alert ID bracelet so the presence of the allergy can be identified easily Stinging-insect allergy can lead to anaphylactic shock. Alerting others to the possibility of an insect sting and allergy is important. To alert others of the allergy, the client should wear a medical alert ID bracelet at all times. A support group may be joined if needed, but is not priority over the client's safety. Genetic testing is not appropriate for allergies. These are tested through allergy testing. It is also not appropriate to recommend testing for foods similar to insect venom.

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 sexually transmitted infections (STIs) Prophylactic treatment for HIV Proper nutrition Screening for HIV

Screening for HIV No screening mandate has been put forth for HIV, but all pregnant women should be encouraged to undergo this test. Prophylactic treatment would be initiated only once the woman has been screened. Screening for STIs and ensuring proper nutrition are also part of health promotion for women in this age group, but they are of lower priority than identifying HIV-positive individuals

The mother of a child with myasthenia gravis has called the clinic and reports her child appears very anxious and the child's heart is beating very fast. What action by the nurse is indicated? Inquire about when the child's last dose of medication was taken. Make an appointment for the child to be seen by the physician within 24 hours. Instruct the child be brought to the emergency department promptly. Inquire about any changes in the child's normal routine.

Instruct the child be brought to the emergency department promptly. Myasthenia gravis is an autoimmune disorder that is characterized by weakness and fatigue. There is no cure. The disease may be aggravated by stress, exposure to extreme temperatures, and infections, resulting in a myasthenic crisis. Myasthenic crisis is a medical emergency with symptoms including sudden respiratory distress, dysphagia, dysarthria, ptosis, diplopia, tachycardia, anxiety, and rapidly increasing weakness. The symptoms reported are consistent with a crisis and prompt care is indicated. Waiting 24 hours to have the child seen by the physician is not appropriate. Questions about changes in routine and medication compliance may be asked but the first priority is to have the child seen.

A school nurse is called to the school cafeteria after a 13-year-old child is reported to have sudden difficulty breathing. The child has a history of asthma and allergies to peanuts. The focused nursing assessment reveals difficulty breathing, inspiratory and expiratory wheezing, swelling of lips, and a rash on the face. The child reports feeling nauseated, having chest tightness, and feeling faint. Complete the following sentence(s) by choosing from the lists of options. The nurse should first address the child's _____ then _____ - rash, wheezing, nausea - swelling of the lips, chest tightness, feeling faint

wheezing swelling of the lips The nurse addresses the airway first; wheezing indicates constriction of the airways. The nurse next addresses the child's swollen lips (angioedema) to ensure there is no additional swelling in the mouth that may occlude the airway. Once the nurse addresses the child's airway, breathing, and circulation, the nurse can address the child's nausea. Because the rash does not interfere with the child's airway, breathing, or circulation, and it will resolve once the allergic episode resolves; this can be addressed later. The child's chest tightness is most likely due to the bronchial constriction. Once the airway constriction resolves, the chest tightness should resolve. The child feeling faint is most likely due to the bronchial constriction reducing airflow. Once the airway constriction resolves, the child should not feel faint.