Adverse effects of frequently administered B-agonist therapy in asthma include all the following EXCEPT

Correct Answer: A

Rationale: In pediatric asthma management, understanding the adverse effects of commonly used medications like B-agonists is crucial. In this scenario, the correct answer is A) bradycardia. Bradycardia is not typically associated with B-agonist therapy; instead, it is more commonly linked with medications that have a parasympathetic effect. Option B) irritability is a possible side effect of B-agonist therapy due to the stimulatory effects on the sympathetic nervous system. Tachycardia, option C, is a common adverse effect of B-agonist therapy as these medications can increase heart rate. Option D) hypokalemia is also a known adverse effect of B-agonist therapy, as they can shift potassium into cells, potentially leading to low serum potassium levels. In an educational context, this question highlights the importance of understanding the potential side effects of medications used in pediatric asthma to ensure safe and effective management. It emphasizes the need for nurses to be knowledgeable about medication effects to monitor and manage pediatric patients effectively. Nurses must be able to recognize and differentiate between common adverse effects to provide appropriate care and prevent complications in pediatric patients with asthma.

Correct Answer: D

Rationale: In this question, the correct answer is D) hydrocortisone. Hydrocortisone is considered the least potent topical steroid used in the treatment of atopic dermatitis. This is because hydrocortisone is a low-potency corticosteroid that is suitable for use on sensitive areas of the body, such as the face, or in pediatric patients. Option A) fluticasone, Option B) desonide, and Option C) betamethasone dipropionate are all more potent topical steroids compared to hydrocortisone. Fluticasone and betamethasone dipropionate are medium to high potency corticosteroids commonly used in the treatment of various skin conditions that require stronger anti-inflammatory effects. Desonide is a mid-potency corticosteroid that is more potent than hydrocortisone but less potent than fluticasone and betamethasone dipropionate. Educationally, understanding the potency of different topical steroids is crucial for healthcare professionals, especially pediatric nurses, who frequently encounter skin conditions like atopic dermatitis in children. Using the least potent steroid like hydrocortisone in appropriate cases helps minimize the risk of side effects associated with higher potency steroids, making it a safer option for pediatric patients. This knowledge ensures safe and effective management of skin conditions in pediatric populations.

Correct Answer: B

Rationale: In the treatment of anaphylactic reactions, particularly those following a Hymenoptera sting, epinephrine is the drug of choice. Epinephrine acts quickly to reverse the severe manifestations of anaphylaxis such as bronchoconstriction, hypotension, and angioedema by stimulating alpha and beta-adrenergic receptors. It helps restore blood pressure, improve breathing, and alleviate swelling, potentially saving a patient's life. Oxygen (Option A) is essential in managing anaphylaxis to support oxygenation, but it does not address the underlying physiological mechanisms driving the severe allergic response. Antihistamines (Option C) are helpful for mild allergic reactions but are not potent or rapid-acting enough to counteract the life-threatening symptoms of anaphylaxis. Corticosteroids (Option D) play a role in preventing biphasic reactions but are not the first-line treatment for acute anaphylaxis due to their delayed onset of action. In an educational context, understanding the rationale behind the use of epinephrine in anaphylaxis is crucial for healthcare providers, especially pediatric nurses who may encounter such emergencies in their practice. Prompt recognition of anaphylactic symptoms and immediate administration of epinephrine can significantly impact patient outcomes and reduce the risk of morbidity and mortality associated with severe allergic reactions.

Correct Answer: C

Rationale: Non-IgE-mediated urticaria, also known as non-allergic urticaria, is a type of hives that is not caused by an allergic reaction. In this case, Epstein-Barr virus (EBV) can be a cause of non-IgE-mediated urticaria. EBV is a common virus that can cause various symptoms, including rash and hives in some cases. The correct answer is C because EBV infection can trigger an immune response leading to hives without involving IgE antibodies. Option A, milk, is a common allergen that can cause IgE-mediated allergic reactions, but it is not typically associated with non-IgE-mediated urticaria. Option B, hymenoptera (bee or wasp) stings, usually trigger IgE-mediated allergic reactions rather than non-IgE-mediated urticaria. Option D, latex, is also known to cause IgE-mediated allergic reactions rather than non-IgE-mediated urticaria. In an educational context, understanding the different mechanisms of allergic reactions is crucial for healthcare professionals, especially pediatric nurses, working with children who may present with hives or other allergic symptoms. Recognizing the various causes and types of urticaria can help nurses provide appropriate care and treatment to pediatric patients. This knowledge can also aid in differentiating between allergic and non-allergic reactions, guiding the management plan effectively.

Correct Answer: C

Rationale: In anaphylaxis, cutaneous symptoms may be absent in approximately 20% of cases. This is because anaphylaxis is a systemic, severe allergic reaction that can present with a wide range of symptoms beyond just skin manifestations. The correct answer, option C (20%), reflects this fact. Option A (5%) is too low of a percentage, as anaphylaxis often involves more than just a small minority of cases without cutaneous symptoms. Option B (10%) is also too low, as it underestimates the frequency of anaphylaxis presentations without cutaneous involvement. Option D (30%) is too high, as cutaneous symptoms are absent in a smaller proportion of anaphylactic cases. Educationally, understanding the variability in anaphylaxis presentations is crucial for healthcare professionals, especially pediatric nurses. Being aware that cutaneous symptoms may be absent in a significant percentage of cases can prevent misdiagnosis or delayed treatment. Nurses play a key role in recognizing and managing anaphylaxis in pediatric patients, so having a comprehensive understanding of the condition is essential for providing safe and effective care.