A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. Once the airway is established, the nurse should do which action? Place in correct sequence. Provide the answer using lowercase letters separated by commas (e.g., a, b, c).

Correct Answer: A

Rationale: In this scenario, the correct action after establishing the airway in a child experiencing an anaphylactic reaction to a bee sting is to administer epinephrine. Epinephrine is the first-line treatment for anaphylaxis as it acts quickly to reverse the severe allergic reaction, especially by constricting blood vessels and relaxing the airway muscles to improve breathing. Keeping the child warm and calm (Option B) is not appropriate in this critical situation as anaphylaxis requires immediate medical intervention. Obtaining vascular access (Option C) is important but is not the initial priority over administering epinephrine to counteract the life-threatening reaction. Singing to the child (Option D) does not address the medical urgency of an anaphylactic reaction and is not a recommended intervention in this case. From an educational perspective, understanding the sequence of interventions in managing anaphylaxis is crucial for healthcare providers, especially in pediatric emergencies. Prioritizing the administration of epinephrine can significantly impact the outcome and save a child's life in such a critical situation.

Correct Answer: B

Rationale: The most likely serum sodium (Na) value for this patient would be within the normal range which is typically between 135-145 mEq/L. A value of 155mEq/L would be considered hypernatremia, which is an elevated level of sodium in the blood, and is not a likely serum sodium value in this case. A level of 110mEq/L would be extremely low and indicate hyponatremia, while a level of 165mEq/L would be dangerously high and could indicate severe hypernatremia. Therefore, option B, 155mEq/L, falls within the normal range and is the most likely serum sodium value for this patient.

Correct Answer: C

Rationale: Circulatory overload is a condition where there is an excessive volume of fluid circulating in the bloodstream. Signs of circulatory overload include moist gurgling respirations, distended neck veins, dyspnea, and coughing. A weak, slow pulse would not be a typical sign of circulatory overload; in fact, it could indicate other conditions such as bradycardia or hypovolemia. Therefore, a weak, slow pulse would not likely occur as a sign of circulatory overload in this scenario.

Correct Answer: B

Rationale: The appropriate nursing diagnosis is Fluid volume deficit R/T uncontrolled vomiting. This diagnosis is the most specific and directly related to the issue of vomiting causing a loss of fluids, leading to a deficit in fluid volume. Uncontrolled vomiting can result in a significant loss of fluids and electrolytes, which can lead to dehydration. It is important to address the root cause of the fluid volume deficit, which in this case is the uncontrolled vomiting. The other options may not directly address the primary issue of fluid loss due to vomiting.

Correct Answer: B

Rationale: The appropriate nursing intervention for a 19-year-old student experiencing symptoms of respiratory alkalosis related to an anxiety attack is to have him breathe into a paper bag. Breathing into a paper bag can help increase the level of carbon dioxide in the body, which can help correct respiratory alkalosis. This technique helps to rebalance the level of carbon dioxide in the blood and alleviate the symptoms of alkalosis caused by hyperventilation during the anxiety attack. It is important to monitor the student's condition and ensure that he is using the paper bag correctly to avoid any potential risks associated with this intervention. Additionally, providing reassurance and support during this episode can also be beneficial in helping the student to manage his anxiety and respiratory alkalosis.