A nurse is caring for a child who has a history of anaphylaxis due to peanut allergy. The nurse should instruct the parents to always have which of the following on hand?

Correct Answer: B

Rationale: In the context of pediatric respiratory distress related to a history of anaphylaxis due to peanut allergy, the correct answer is B) An epinephrine auto-injector. This is because anaphylaxis is a severe and potentially life-threatening allergic reaction that can rapidly progress, leading to respiratory distress, among other symptoms. Epinephrine is the first-line treatment for anaphylaxis as it acts quickly to reverse the allergic response, including respiratory compromise. Therefore, having an epinephrine auto-injector readily available is crucial in managing anaphylaxis effectively and promptly. Antihistamines (Option A) are used to treat mild allergic reactions but are not sufficient for the treatment of anaphylaxis, especially when respiratory distress is involved. Corticosteroids (Option C) may be used as an adjunct therapy in the treatment of anaphylaxis, but they are not the primary intervention for acute respiratory distress in this context. Oral antihistamine medication (Option D) is not appropriate for the management of acute anaphylaxis, especially when respiratory distress is a concern. In an educational context, it is essential for nurses and healthcare providers to educate parents of children with known severe allergies, like peanut allergy, about the importance of having an epinephrine auto-injector available at all times. Teaching parents how to recognize the signs of anaphylaxis and when to administer epinephrine can be life-saving for their child in the event of an allergic reaction. Timely administration of epinephrine is crucial in preventing the progression of symptoms, including respiratory distress, and improving outcomes for children with severe allergies.

Correct Answer: B

Rationale: In pediatric respiratory distress cases, dehydration can be a significant concern due to increased respiratory rate and fluid loss. Choosing option B, "Dry mouth and decreased tear production," as the correct answer is crucial because these signs indicate dehydration in children. Dry mouth is a common symptom of dehydration, and decreased tear production can also be an indicator of reduced fluid volume in the body. Option A, "Increase in urination," is more commonly associated with conditions like diabetes or kidney issues rather than dehydration. While dehydration can lead to concentrated urine and decreased urination, the primary focus should be on signs of fluid loss rather than increased urination. Option C, "Warm skin with no perspiration," does not directly correlate with dehydration. Dehydration can lead to cool, clammy skin rather than warm skin with no perspiration. This option is more indicative of potential fever rather than dehydration. Option D, "Increased appetite and irritability," are not typical signs of dehydration in pediatric patients. Increased appetite can be a sign of growth or developmental changes, and irritability can be a common behavioral response to illness but does not directly relate to dehydration. Educationally, it is essential for nurses and parents to recognize the early signs of dehydration in children, especially in cases of respiratory distress where fluid balance is crucial for optimal respiratory function. Monitoring for signs like dry mouth and decreased tear production can help in early intervention and prevention of complications related to dehydration in pediatric patients.

Correct Answer: A

Rationale: The correct interpretation of the term "legal blindness" is option A) A legal definition that determines whether the individual can receive benefits from government or ancillary agencies. In pediatric respiratory distress nursing interventions, understanding the term legal blindness is crucial for providing holistic care to children with visual impairments. Option B is incorrect as legal blindness is not solely about needing glasses but rather a legal classification based on specific criteria. Option C is incorrect as an acuity test result of 20/100 alone does not determine legal blindness; legal blindness is defined by specific legal criteria beyond just visual acuity. Option D is incorrect as legal blindness is a legal status rather than a medical diagnosis. In an educational context, nurses need to understand the legal implications of visual impairment to advocate for appropriate services and support for pediatric patients. By knowing the criteria for legal blindness, nurses can ensure that children with visual impairments receive the necessary resources to thrive in their environment. Understanding legal definitions related to healthcare is essential for providing comprehensive care to pediatric patients with complex needs.

Correct Answer: D

Rationale: In pediatric nursing, understanding the indicators of lung maturity in infants is crucial for providing appropriate care. In this scenario, the correct answer is D) Levels of phosphatidylglycerol and phosphatidylcholine. Phosphatidylglycerol and phosphatidylcholine are two specific surfactant components that are present in the amniotic fluid when fetal lungs are mature. A high level of these phospholipids indicates fetal lung maturity, as they are essential for reducing surface tension in the alveoli and preventing collapse. Option A) Levels of prednisone is incorrect because prednisone is a corticosteroid medication and is not a marker of lung maturity. Option B) Levels of epidermal growth factor is incorrect as it is a protein that promotes cell growth and differentiation, not specifically indicative of lung maturity. Option C) Levels of prostaglandins is also incorrect as prostaglandins are lipid compounds involved in inflammation and smooth muscle contraction, not directly related to lung maturity. Educationally, understanding these specific tests of amniotic fluid can help nurses assess the respiratory status of newborns and intervene promptly if necessary. Monitoring these indicators can guide healthcare providers in determining the need for interventions such as surfactant replacement therapy or respiratory support for infants at risk of respiratory distress syndrome. It is important for pediatric nurses to be knowledgeable about these markers to provide optimal care for neonates experiencing respiratory distress.

Correct Answer: C

Rationale: The correct answer is C) Increased systemic vascular resistance. In fetal circulation, the foramen ovale allows blood to bypass the non-functioning fetal lungs by shunting blood from the right atrium to the left atrium. This right-to-left shunt ceases and the foramen ovale closes after birth due to an increase in systemic vascular resistance. Option A is incorrect because increased levels of PO2 in the blood of the neonate occur after birth as the newborn starts breathing, but it does not directly cause the closure of the foramen ovale. Option B is incorrect because decreased levels of PCO2 in the blood of the newborn also occur after birth due to the initiation of breathing, but it is not the primary factor leading to the closure of the foramen ovale. Option D is incorrect as the removal of the placenta does lead to a decrease in blood volume returning to the right side of the fetal heart, but this alone does not cause the cessation of the right-to-left shunt through the foramen ovale. Understanding the physiological changes during the transition from fetal to neonatal circulation is crucial for pediatric nurses to provide appropriate care for newborns experiencing respiratory distress and to intervene promptly in case of complications related to the closure of fetal shunts.