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

Correct Answer: A

Rationale: In pediatric nursing, understanding the adverse effects of frequently administered B-agonist therapy in asthma is crucial for safe and effective patient care. In this question, the correct answer is A) bradycardia. Bradycardia is not a typical adverse effect of B-agonist therapy; in fact, B-agonists such as albuterol usually lead to an increase in heart rate (tachycardia) due to their stimulatory effect on beta receptors in the heart. Option B) irritability is a possible adverse effect of B-agonist therapy, as these medications can sometimes cause nervous system stimulation leading to irritability in pediatric patients. Option C) tachycardia is a common adverse effect of B-agonist therapy due to the medication's stimulatory effect on beta receptors in the heart, leading to an increased heart rate. Option D) hypokalemia is another potential adverse effect of B-agonist therapy, as these medications can shift potassium into cells, potentially lowering serum potassium levels. Educationally, it is essential for pediatric nurses to be aware of the potential adverse effects of common asthma medications like B-agonists to monitor patients for any signs of complications. Understanding these effects enables nurses to provide safe and individualized care, monitor for adverse reactions, and intervene promptly if needed to ensure positive patient outcomes.

Correct Answer: D

Rationale: In this question, the correct answer is D) hydrocortisone. Hydrocortisone is the least potent topical steroid used in the treatment of atopic dermatitis. Hydrocortisone is a low-potency corticosteroid that is suitable for use on delicate areas of the skin such as the face, groin, and armpits. It is often recommended for mild cases of atopic dermatitis or for use on children due to its lower potency and decreased risk of side effects compared to stronger steroids. The other options (A) fluticasone, (B) desonide, and (C) betamethasone dipropionate are all more potent topical steroids. Fluticasone, desonide, and betamethasone dipropionate are higher in potency and are typically reserved for more severe cases of atopic dermatitis or for areas of thicker skin where stronger medication may be required. In an educational context, understanding the potency of different topical steroids is crucial for pediatric nurses when managing skin conditions like atopic dermatitis in children. It is important to match the potency of the steroid with the severity of the condition and the age of the patient to ensure effective treatment while minimizing the risk of adverse effects.

Correct Answer: B

Rationale: In the management of anaphylactic reactions, especially those caused by Hymenoptera stings, epinephrine is the drug of choice. Epinephrine acts quickly to reverse the life-threatening symptoms of anaphylaxis by constricting blood vessels, increasing heart rate, opening airways, and reducing swelling. This rapid action is crucial in preventing severe complications and potential fatality. Oxygen (Option A) is important in supporting respiratory function during anaphylaxis but is not the primary treatment. Antihistamines (Option C) may help relieve itching and hives but do not address the severe cardiovascular and respiratory effects of anaphylaxis. Corticosteroids (Option D) have a delayed onset of action and are not considered first-line treatment for acute anaphylaxis. In an educational context, understanding the importance of prompt and effective treatment for anaphylaxis is vital for healthcare providers, especially pediatric nurses. Recognizing the signs and symptoms of anaphylaxis, knowing the appropriate interventions, and being able to quickly administer epinephrine can save lives in pediatric emergencies. It is essential for nurses to be well-versed in evidence-based practices to ensure positive patient outcomes.

Correct Answer: C

Rationale: Non-IgE-mediated urticaria is caused by Epstein-Barr virus (EBV) because this viral infection can trigger a delayed hypersensitivity reaction leading to skin manifestations like urticaria. EBV can induce immune responses that result in inflammation and skin rashes, characteristic of non-IgE-mediated urticaria. Option A, milk, is incorrect because milk allergy typically triggers an IgE-mediated response, not non-IgE-mediated urticaria. Hymenoptera venom (Option B) usually causes IgE-mediated allergic reactions or venom hypersensitivity, not non-IgE-mediated urticaria. Latex (Option D) can lead to allergic reactions, but these are predominantly IgE-mediated. In an educational context, understanding the different mechanisms of allergic reactions is crucial for pediatric nurses to accurately assess, diagnose, and manage pediatric patients presenting with urticaria. Recognizing the specific triggers for non-IgE-mediated urticaria, such as viral infections like EBV, helps nurses provide appropriate care and interventions for affected children.

Correct Answer: C

Rationale: In the context of pediatric nursing and anaphylaxis, it is crucial to understand the presentation of symptoms to provide timely and effective care to children. The correct answer, option C) 20%, is the most appropriate choice because anaphylaxis can present with cutaneous symptoms being absent in approximately 20% of cases. This fact highlights the variability in symptomatology that can occur during an anaphylactic reaction, emphasizing the need for healthcare providers to consider a wide range of possible presentations in pediatric patients. Options A) 5%, B) 10%, and D) 30% are incorrect because they do not accurately reflect the percentage of anaphylactic cases where cutaneous symptoms may be absent. Understanding this specific percentage is crucial in pediatric nursing practice to avoid overlooking potential cases of anaphylaxis that may present without typical skin manifestations like hives or rash. Educationally, this question serves to reinforce the importance of comprehensive knowledge in pediatric nursing, particularly in recognizing and managing life-threatening conditions like anaphylaxis. By understanding the nuances of symptom presentation, nurses can enhance their clinical assessment skills and provide prompt interventions to pediatric patients experiencing allergic reactions. This question underscores the need for pediatric nurses to maintain a high level of vigilance and proficiency in handling emergent situations in pediatric care settings.