A 10-year-old child is being discharged after being admitted for status asthmaticus. Which instruction is most important for the nurse to include in the discharge teaching?

Correct Answer: A

Rationale: In the context of pediatric nursing, the most important instruction for a 10-year-old child being discharged after an admission for status asthmaticus is to use a peak flow meter daily to monitor asthma control. This is crucial because it empowers the child and caregivers to actively assess the severity of asthma symptoms and response to treatment at home. Monitoring peak flow readings can help detect early signs of worsening asthma and guide timely intervention. Avoiding exposure to known allergens (option B) is important in asthma management, but it is not as immediate and actionable as daily peak flow monitoring. Continuing to take asthma medications as prescribed (option C) is essential for long-term management but does not provide real-time assessment of asthma control. Seeking emergency care if symptoms worsen (option D) is important, but regular monitoring with a peak flow meter can help prevent exacerbations that lead to emergency situations. Educationally, teaching the importance of daily peak flow monitoring reinforces the concept of self-management and empowers the child to take an active role in their asthma care. It also emphasizes the value of proactive monitoring and early intervention in chronic conditions like asthma, promoting better outcomes and quality of life.

Correct Answer: B

Rationale: The correct intervention to help prevent injury during a seizure is to keep the side rails padded and in an upright position. This measure helps to ensure the child's safety by preventing falls or accidental injuries. Using a padded tongue depressor or restraining the child can potentially cause harm and are not recommended. Placing a padded helmet is not a standard intervention for seizure safety in this scenario.

Correct Answer: A

Rationale: Assessing tube placement is critical before initiating a tube feeding to verify its correct positioning in the stomach. This assessment helps prevent potential complications such as aspiration if the tube is incorrectly placed in the respiratory tract. Checking bowel sounds, abdominal circumference, and tube patency are important assessments in the care of a child receiving tube feedings, but ensuring proper tube placement takes precedence to ensure safe and effective delivery of nutrition.

Correct Answer: C

Rationale: Labored breathing is a critical sign of worsening respiratory distress in children with RSV. It indicates that the child's condition may be deteriorating, requiring prompt intervention to ensure adequate oxygenation and prevent respiratory failure. Monitoring for labored breathing allows healthcare providers to promptly assess and manage the child's respiratory status, potentially preventing further complications associated with RSV infection.

Correct Answer: B

Rationale: The priority intervention for a 5-year-old child with leukemia receiving chemotherapy and having a low white blood cell count is to place the child in protective isolation. This intervention helps reduce the risk of infection, which is crucial in this immunocompromised state. Protective isolation aims to limit the child's exposure to pathogens and promote their safety during a period of increased vulnerability to infections.