Disorders associated with elevated IgE include all the following EXCEPT

Correct Answer: C

Rationale: Elevated IgE levels are commonly associated with allergic conditions and parasitic infections. In this case, the correct answer is C) Chediak-Higashi syndrome. This is because Chediak-Higashi syndrome is a rare genetic disorder characterized by recurrent infections, partial albinism, and peripheral neuropathy; it is not directly linked to elevated IgE levels. Option A) Atopic dermatitis (eczema) is linked to elevated IgE levels due to its allergic nature. Option B) Tissue-invasive helminthic infections also lead to elevated IgE levels as a response to parasitic infestations. Option D) Hodgkin disease is associated with elevated IgE levels as part of the immune response to the disease. Educationally, understanding the link between IgE levels and various disorders is crucial for pediatric nursing practice. Recognizing these associations helps nurses in providing comprehensive care to pediatric patients with these conditions. It also highlights the importance of assessing IgE levels in diagnosing and managing allergic and infectious diseases in children.

Correct Answer: C

Rationale: In pediatric nursing, understanding the relationship between allergic rhinitis and reactive airways disease/asthma is crucial. The correct answer is C) 50%. Children with allergic rhinitis have a higher likelihood of developing reactive airways disease/asthma, with studies indicating that around 50% of children with allergic rhinitis also have symptoms of asthma. This association is due to the shared inflammatory processes in the airways triggered by allergens, leading to symptoms like coughing, wheezing, and shortness of breath. Option A) 30% is incorrect because the prevalence of reactive airways disease/asthma in children with allergic rhinitis is higher than 30%. Option B) 40% is also incorrect as the actual percentage is higher. Option D) 60% is incorrect as it overestimates the association between allergic rhinitis and reactive airways disease/asthma in children. Educationally, understanding this relationship is important for pediatric nurses to provide comprehensive care to children with allergic rhinitis and to monitor for signs and symptoms of reactive airways disease/asthma. Recognizing these connections can lead to early intervention, appropriate treatment, and improved outcomes for pediatric patients.

Correct Answer: D

Rationale: In the management of anaphylaxis, the mainstay of therapy is the early administration of intramuscular epinephrine (option D). Epinephrine acts quickly to reverse the severe manifestations of anaphylaxis by constricting blood vessels, relaxing bronchial muscles, and increasing the heart's contraction force. Corticosteroids (option A) may be used as an adjunct therapy to prevent a potential late-phase allergic reaction but are not the primary treatment for acute anaphylaxis. Antihistamines (option B) and H2-receptor antagonists (option C) can help alleviate itching and hives in mild allergic reactions but are not as rapidly effective as epinephrine in the treatment of anaphylaxis. In an educational context, it is crucial for healthcare providers, especially pediatric nurses, to understand the urgency of recognizing and treating anaphylaxis promptly. Proper training on the signs and symptoms of anaphylaxis and the correct administration of epinephrine can save lives in pediatric emergencies. Nurses should be equipped with the knowledge and skills to initiate immediate treatment with epinephrine while awaiting further medical assistance.

Correct Answer: A

Rationale: The most likely diagnosis for the 4-year-old boy presenting with failure to thrive, irritability, bloating, and a symmetrical rash on his elbows and knees with positive Transglutaminase IgA antibodies is A) Dermatitis herpetiformis. Dermatitis herpetiformis is a chronic autoimmune blistering skin condition linked to gluten sensitivity. The presence of positive Transglutaminase IgA antibodies suggests an underlying gluten-related disorder, such as celiac disease, which commonly presents with dermatitis herpetiformis. The symmetrical rash on elbows and knees is a classic presentation of dermatitis herpetiformis. B) Discoid eczema is a localized form of eczema typically presenting as coin-shaped patches of irritated skin, not associated with gluten sensitivity or the other symptoms described. C) Henoch–Schönlein purpura is a systemic vasculitis affecting small blood vessels, leading to a characteristic rash, joint pain, abdominal pain, and kidney involvement. It is not typically associated with the described symptoms or positive Transglutaminase IgA antibodies. D) Impetigo is a bacterial skin infection characterized by honey-colored crusts on the skin, not related to gluten sensitivity or presenting with the specific symptoms described. Educationally, understanding the clinical manifestations, diagnostic criteria, and associations of dermatitis herpetiformis is crucial for pediatric nurses to provide comprehensive care to children with gluten-related disorders. Recognizing the importance of linking skin manifestations to underlying systemic conditions like celiac disease can aid in early detection and management of such conditions in pediatric patients.

Correct Answer: A

Rationale: The correct management for a 1-year-old child presenting with urticaria and wheeze after eating peanut butter is option A) 0.1 mL of 1:1000 IM adrenaline. This is the correct choice because in cases of anaphylaxis, which can present with symptoms like urticaria and wheezing, prompt administration of adrenaline is crucial to reverse the potentially life-threatening effects of the allergic reaction. The 1:1000 concentration is recommended for pediatric patients due to their smaller size and weight. Option B) 0.1 mL of 1:10,000 IM adrenaline is incorrect as the concentration is too low for immediate and effective management of anaphylaxis in this scenario. Option C) 1 mL of 1:10,000 IM adrenaline is too high a dose for a pediatric patient and could lead to adverse effects. Option D) 0.1 mL of 1:10,000 SC adrenaline is not the preferred route of administration for anaphylaxis as IM injection leads to quicker absorption and onset of action. In an educational context, understanding the appropriate management of anaphylaxis in pediatric patients is vital for healthcare providers working in settings where children are cared for, such as pediatric clinics, emergency departments, and schools. Adherence to evidence-based practices ensures the best outcomes for pediatric patients experiencing allergic reactions.