A 10-year-old child has intermittent symptoms of mild asthma... Which treatment option is most appropriate?

Correct Answer: D

Rationale: The most appropriate treatment option for a 10-year-old child with intermittent symptoms of mild asthma is option D, which is the inhaled β₂-agonist as needed for symptoms. Explanation of why D is correct: - Inhaled β₂-agonists are quick-relief medications that help to relax the muscles around the airways during an asthma attack, providing rapid relief of symptoms such as wheezing, coughing, and shortness of breath. - This treatment option is suitable for mild asthma symptoms and is recommended as the first-line therapy for acute symptom relief in asthma management guidelines. Explanation of why others are wrong: - Option A (Environmental control and patient education only) alone may not be sufficient to manage asthma symptoms and may lead to inadequate control of the condition. - Option B (Oral theophylline) is not typically recommended as a first-line treatment for mild asthma in children due to its potential side effects, narrow therapeutic window, and interactions with other medications. - Option C (Cromolyn) is a mast cell stabilizer that is more suitable for the prevention of asthma symptoms rather than providing immediate relief during an asthma attack. Educational context: It is crucial for pediatric clinical nurse specialists to have a deep understanding of asthma management in children. By choosing the appropriate treatment option, such as inhaled β₂-agonists for acute symptom relief in mild asthma cases, healthcare providers can help improve the quality of life for pediatric patients with asthma. Educating patients and families on proper medication administration techniques and asthma triggers is also essential for long-term asthma management.

Correct Answer: D

Rationale: In this question, the correct answer is D) Food handlers. Latex allergy is commonly seen in healthcare workers, spina bifida patients, and atopic individuals due to repeated exposure to latex products. Healthcare workers often come into contact with latex gloves and medical devices, spina bifida patients undergo multiple surgeries and medical procedures involving latex-containing products, and atopic individuals may have a predisposition to developing allergies, including latex allergy. Food handlers, on the other hand, are not typically exposed to latex in their daily tasks unless they work in a healthcare setting where latex gloves are used. This makes option D the correct answer as it is not a common cause of latex allergy compared to the other groups mentioned. From an educational perspective, understanding the common causes of latex allergy is important for healthcare professionals, especially Pediatric Clinical Nurse Specialists who work with vulnerable populations like children with spina bifida. Recognizing potential allergens and taking appropriate precautions can help prevent allergic reactions and provide better care for patients. It also highlights the importance of using non-latex alternatives in healthcare settings to reduce the risk of allergic reactions among both patients and healthcare workers.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Respiratory acidosis, partially compensated. This interpretation is based on the arterial blood gas results showing a low pH (acidosis) along with an elevated PaCO2 (respiratory component) and an elevated HCO3 (metabolic compensation). Option A) Respiratory acidosis, uncompensated is incorrect because there is evidence of metabolic compensation with an elevated HCO3 level. Option C) Metabolic acidosis, partially uncompensated is incorrect as the primary issue is respiratory acidosis with metabolic compensation. Option D) Metabolic alkalosis, uncompensated is incorrect as the blood gas results clearly indicate acidosis, not alkalosis. In an educational context, understanding arterial blood gas interpretation is crucial for pediatric clinical nurse specialists to assess and manage respiratory conditions effectively. This case highlights the importance of recognizing respiratory acidosis, understanding compensatory mechanisms, and differentiating primary and compensatory disorders in pediatric patients with respiratory distress.

Correct Answer: C

Rationale: The main diagnostic sign of cardiac arrest is the absence of a central pulse, which signifies the cessation of effective heart function. In a pediatric patient, this is a critical indicator of cardiac arrest due to the immediate threat it poses to the child's life. Option A, apnea, although it can be a symptom of cardiac arrest, is not the main diagnostic sign. A child may have stopped breathing due to various reasons other than cardiac arrest. Option B, shock, is a state of circulatory collapse and inadequate tissue perfusion. While shock can be a consequence of cardiac arrest, it is not the main diagnostic sign. Option D, absence of peripheral pulse, is also a possible sign of cardiac arrest, but it is not as reliable or as easily detectable as the absence of a central pulse. Educationally, understanding the key diagnostic signs of cardiac arrest in pediatric patients is crucial for healthcare providers, especially for Pediatric Clinical Nurse Specialists. Recognizing these signs promptly is essential for initiating immediate life-saving interventions such as CPR and defibrillation. This knowledge can make a significant difference in the outcomes of pediatric patients experiencing cardiac emergencies.

Correct Answer: D

Rationale: The correct answer is D) Expelling a foreign body in the airway in the unconscious child. The Heimlich maneuver, also known as abdominal thrusts, is a first aid procedure used to help a choking person who is conscious or unconscious by expelling a foreign object blocking the airway. In the context of pediatric care, this maneuver is crucial as children are prone to putting small objects in their mouths. Option A, opening the airway in the presence of possible cervical spine injury, is incorrect because the Heimlich maneuver is not indicated for this purpose. Performing the maneuver in such cases could exacerbate the spinal injury. Option B, restoring spontaneous circulation in children with cardiac arrest, is also incorrect. The Heimlich maneuver is not intended for treating cardiac arrest but rather for clearing a blocked airway to enable breathing. Option C, chest compression in a large child to ensure adequate compression, is not the purpose of the Heimlich maneuver. Chest compressions are part of cardiopulmonary resuscitation (CPR) and are used in cases of cardiac arrest, not choking. In an educational context, it is essential for healthcare providers, especially pediatric clinical nurse specialists, to be well-versed in performing the Heimlich maneuver correctly to effectively manage choking emergencies in children. Understanding the correct indications and techniques for this maneuver can make a significant difference in saving a child's life during a choking incident.