A TRUE indication of venom immunotherapy in a six-year-old boy is

Correct Answer: D

Rationale: In pediatric nursing, understanding indications for venom immunotherapy is crucial for safe and effective care. The correct answer, option D, is the systemic reaction with a positive skin test and negative in vitro test. This indicates a true systemic allergic reaction to a specific venom, warranting venom immunotherapy to desensitize the child to the allergen. Option A, a large local reaction with positive skin and in vitro tests, typically does not warrant venom immunotherapy as it suggests a localized, rather than systemic, reaction. Option B, a generalized cutaneous reaction with a positive skin test and negative in vitro test, also does not meet the criteria for venom immunotherapy as it lacks a systemic component. Option C, a generalized cutaneous reaction with a positive in vitro test and negative skin test, is not indicative of venom immunotherapy as a positive skin test is typically required for diagnosis. Educationally, understanding the nuances of allergic reactions and the specific criteria for venom immunotherapy in pediatric patients ensures accurate assessment and appropriate treatment. Recognizing the combination of systemic symptoms and specific test results is essential for providing optimal care to children with venom allergies.

Correct Answer: D

Rationale: The correct answer is D) plasma tryptase. Plasma tryptase is the best diagnostic test for anaphylaxis in a child due to its specificity and sensitivity in detecting mast cell activation, which is a key feature of anaphylaxis. Tryptase levels rise early during an anaphylactic reaction and can remain elevated for several hours, making it a reliable marker to confirm the diagnosis. Option A) plasma histamine is not as specific for anaphylaxis as tryptase. Histamine levels can be affected by various factors and may not always correlate with the severity of an allergic reaction. Option B) skin tests are used to identify specific allergens triggering allergic reactions, but they are not diagnostic for anaphylaxis itself. Option C) radioallergosorbent assay (RAST) is a blood test that measures the amount of specific IgE antibodies to particular allergens. While useful for identifying triggers for allergic reactions, it is not specific for diagnosing anaphylaxis. In an educational context, understanding the most appropriate diagnostic tests for anaphylaxis is crucial for pediatric nurses to provide prompt and accurate care to children experiencing severe allergic reactions. Knowledge of specific markers like plasma tryptase can guide clinical decision-making and help in initiating timely interventions to manage anaphylaxis effectively.

Correct Answer: D

Rationale: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated gastrointestinal food hypersensitivity that primarily affects infants and young children. The correct answer, D, "commonly improved with ingestion of soy protein-based formula," is correct because FPIES is commonly triggered by cow's milk or soy proteins. However, using a soy protein-based formula can worsen symptoms in these patients. Option A, "manifests in the first months of life," is a characteristic feature of FPIES as symptoms typically present in infancy. Option B, "vomiting occurs 1-3 hours after feeding," is also a common presentation of FPIES, with delayed onset vomiting being a hallmark symptom. Option C, "hypotension occurs in approximately 15% of cases," is incorrect as hypotension is not a common feature of FPIES; dehydration due to vomiting is more common. Educationally, it is crucial to understand the distinguishing features of FPIES to provide appropriate care and support to affected children and their families. Recognizing the symptoms, triggers, and appropriate management strategies, such as eliminating the offending food proteins, is essential in the nursing care of pediatric patients with FPIES. Additionally, highlighting the potential risks of alternative formulas, like soy-based formulas in FPIES, underscores the importance of accurate nutritional management in these cases.

Correct Answer: D

Rationale: Allopurinol is a medication commonly used to treat gout and high levels of uric acid in the blood. It is known to cause allergic reactions in some individuals. In this case, the correct answer is D) pulmonary fibrosis, as this condition is not typically associated with allopurinol use. Option A) exanthem, B) Stevens-Johnson syndrome, and C) toxic epidermal necrolysis are all known potential allergic reactions to allopurinol. Exanthem refers to a widespread rash, while Stevens-Johnson syndrome and toxic epidermal necrolysis are severe skin conditions that can be life-threatening. In an educational context, it is crucial for healthcare professionals, especially pediatric nurses, to be aware of potential adverse reactions to medications commonly used in children. Understanding the possible allergic reactions to allopurinol can help nurses in monitoring and managing pediatric patients who are prescribed this medication. By knowing which reactions are associated with allopurinol use, nurses can provide safe and effective care to their young patients.

Correct Answer: A

Rationale: In pediatric nursing, recognizing signs and symptoms of various conditions is crucial for providing effective care. Extreme eosinophilia, which refers to an abnormally high level of eosinophils in the blood, suggests a drug reaction. Eosinophils are a type of white blood cell involved in allergic reactions. When a medication triggers an immune response, it can result in extreme eosinophilia as the body tries to fight off the perceived threat. Option A, a drug reaction, is the correct answer because medications can elicit immune responses leading to extreme eosinophilia. Options B, C, and D, which are allergic rhinitis, atopic dermatitis, and asthma, respectively, are conditions associated with allergic responses but not specifically linked to extreme eosinophilia caused by drug reactions. In an educational context, understanding the significance of extreme eosinophilia can help healthcare providers identify potential adverse drug reactions in pediatric patients. It underscores the importance of thorough patient assessments, monitoring for unusual laboratory findings, and considering the possibility of medication-related complications in clinical practice. By mastering this concept, nurses can enhance their clinical judgment and provide safer care to pediatric patients.