How does the nurse interpret laboratory analysis of a stool sample containing excessive azotorrhea and steatorrhea in a child with cystic fibrosis (CF)?

Correct Answer: B

Rationale: The correct answer is B) Not compliant with taking her enzymes. In cystic fibrosis (CF), the pancreas is often affected, leading to pancreatic insufficiency. This results in a deficiency of digestive enzymes like lipase, amylase, and protease, necessary for proper digestion. This deficiency leads to malabsorption of fats (steatorrhea) and proteins (azotorrhea), as seen in the stool sample analysis. Option A) Not compliant with taking her vitamins is incorrect because the primary issue in CF related to digestion is the lack of pancreatic enzymes, not vitamins. While CF patients may also have fat-soluble vitamin deficiencies due to malabsorption, the primary concern is the lack of enzymes. Option C) Eating too many foods high in fat is incorrect because the issue lies in the child's inability to digest and absorb fats due to the lack of enzymes, not the quantity of fat intake. Option D) Eating too many foods high in fiber is incorrect because fiber does not directly contribute to the malabsorption of fats and proteins seen in CF. The main issue in CF is the lack of pancreatic enzymes necessary for digestion, not fiber intake. Understanding these concepts is crucial for pediatric nurses caring for children with CF. Proper administration of pancreatic enzyme replacement therapy is essential to support digestion and prevent malabsorption-related complications in these patients. Educating patients and families on the importance of enzyme compliance can improve outcomes and quality of life for children with CF.

Correct Answer: D

Rationale: The correct answer is D) Avoid purchasing upholstered furniture. Parents of a child with asthma should aim to make their home as allergy-free as possible to minimize triggers that can exacerbate asthma symptoms. Upholstered furniture can harbor dust mites, pet dander, and other allergens that can worsen asthma. Choosing furniture made of easy-to-clean materials like wood or leather can help reduce allergen exposure in the home. Option A, using a humidifier, is not recommended as it can actually increase humidity levels and promote mold and dust mite growth, worsening allergies and asthma symptoms. Option B, chemically cleaning the carpet once a month, can introduce more irritants into the environment and may not be necessary if regular vacuuming with a HEPA filter vacuum is done. Option C, washing household pets weekly, may not be practical or necessary if the child is not specifically allergic to pet dander. For educational context, it is important for pediatric nurses to educate parents on creating an asthma-friendly environment at home. Understanding common allergens and triggers, as well as practical steps to minimize exposure, can significantly improve the quality of life for children with asthma. Encouraging parents to make informed choices about home furnishings and cleaning practices can help manage asthma symptoms and reduce the need for medical interventions.

Correct Answer: D

Rationale: In a situation where a child is experiencing status asthmaticus, the most critical piece of information the nurse must ask the parent is when was the child's last dose of medication (Option D). This is because the timing of the last dose of medication can significantly impact the current status of the child's asthma and guide the next steps in their care. Option A, asking about the time the child ate last, while important for some conditions, is not as crucial as knowing about the medication in an acute asthma exacerbation. Option B, inquiring about asthma triggers, though relevant for long-term management, is not as urgent as the timing of medication during an acute episode. Option C, asking about the last admission for asthma, is retrospective and does not provide real-time information needed for immediate intervention. In an educational context, understanding the significance of timing in medication administration and its impact on acute asthma exacerbations is crucial for pediatric respiratory nursing. Nurses must prioritize assessing and acting on information that directly influences the current state of a child's respiratory health to provide timely and appropriate care.

Correct Answer: C

Rationale: In this scenario, the correct answer is option C, the 9-year-old who is quiet, pale, and wheezing bilaterally with an oxygen saturation of 92%. This child should be seen first because they are showing signs of respiratory distress, such as pallor, quietness, and decreased oxygen saturation. These are concerning signs indicating a worsening condition requiring immediate attention. Option A, the 12-month-old with diminished breath sounds and oxygen saturation of 93%, also presents with worrisome symptoms, but the presence of pallor in option C indicates a more severe situation. Option B, the 5-year-old, despite speaking in complete sentences and being pink in color, is wheezing bilaterally and has a low oxygen saturation level, needing prompt assessment as well. Option D, the 16-year-old, is managing to speak and maintain relatively higher oxygen saturation compared to the others, making them a lower priority for immediate intervention. Educationally, this question highlights the importance of recognizing signs of respiratory distress in pediatric patients with asthma. It emphasizes the need for nurses to prioritize care based on the severity of symptoms and vital signs, ensuring timely interventions to prevent further deterioration in children with respiratory conditions like asthma.

Correct Answer: D

Rationale: The most appropriate intervention to teach the mother of a child with an upper respiratory infection (URI) and a dry, hacking cough that prevents sleep is option D: Give 1/2 teaspoon of honey four to five times per day. Rationale: Honey has been shown to be an effective and safe remedy for cough in children over the age of 1 year. It has natural soothing and antimicrobial properties that can help alleviate cough symptoms, especially at night, allowing the child and parent to get much-needed rest. Why others are wrong: A) Giving cough suppressants at night can be dangerous for young children and may lead to respiratory suppression, especially in cases of URI. B) Expectorants may not be suitable for a dry, hacking cough as they work by increasing mucus production to help clear the airways, which is not the issue in this scenario. C) Cold and flu medications often contain multiple ingredients, some of which may not be appropriate for young children and may not specifically target cough symptoms in this case. Educational context: It is crucial for parents to understand the appropriate remedies for common childhood illnesses like URIs. Educating them on evidence-based practices, such as using honey for cough relief in children over 1 year old, helps empower them to provide safe and effective care for their child. Parents should always consult with healthcare providers before administering any remedies to ensure they are appropriate for their child's age and condition.