The nurse determines that a client who arrives in the preoperative holding area before surgery is allergic to bananas. Which action should the nurse implement prior to taking the client into the operative area?

Correct Answer: A

Rationale: In this scenario, the correct action is to replace latex-containing devices in the operating room with alternate synthetic materials. This is crucial because the client has a known allergy to bananas, and individuals with latex allergies often have cross-reactivity with certain fruits like bananas due to shared allergenic proteins. Latex can be found in many medical devices, and exposure during surgery can lead to a severe allergic reaction in sensitive individuals. Option B, administering an antihistamine before surgery, is not the most appropriate action in this situation. While antihistamines can help manage allergic symptoms, preventing exposure to latex is the priority to avoid a potential life-threatening reaction. Option C, notifying the surgeon about the client's banana allergy, is important but does not directly address the risk of latex exposure in the operating room. It is essential for the surgical team to be aware of all allergies, but the nurse must also take immediate action to prevent latex exposure. Option D, preparing to administer an epinephrine injection during surgery, is a reactive measure and should not be the primary strategy. Preventing exposure to the allergen is key in managing allergies effectively. Educationally, this question highlights the importance of thorough assessment, patient safety, and knowledge of common allergens in healthcare settings. Understanding cross-reactivity between latex and certain fruits is crucial for nurses to provide safe care and prevent adverse events in allergic individuals.

Correct Answer: C

Rationale: In the acute phase of Kawasaki Disease, conjunctival hyperemia is a key clinical manifestation. This is because Kawasaki Disease is characterized by systemic vasculitis affecting medium-sized arteries, including the coronary arteries. Conjunctival hyperemia, along with other symptoms like rash, fever, and mucous membrane changes, are indicative of the inflammatory process affecting the blood vessels in the eyes. Option A, cracked lips, is a common finding in conditions like dehydration or vitamin deficiencies but is not specific to Kawasaki Disease. Option B, normal appearance, is unlikely in a child with Kawasaki Disease due to the systemic inflammation present. Option D, desquamation of the skin, typically occurs later in the subacute phase of the disease and is not a hallmark of the acute phase. Educationally, understanding the clinical manifestations of Kawasaki Disease is crucial for nurses caring for pediatric patients. Recognizing these signs early can lead to prompt treatment, which is essential in preventing complications such as coronary artery aneurysms. Nurses play a vital role in early identification and management of Kawasaki Disease, highlighting the importance of knowledge in assessing and caring for children with this condition.

Correct Answer: D

Rationale: The correct answer is D) “Did your child have a sore throat or fever within the last 2 months?” This question is crucial in assessing the potential development of rheumatic fever because it is often preceded by a group A beta-hemolytic streptococcal infection, such as strep throat. Rheumatic fever typically occurs 2-4 weeks after an untreated or inadequately treated strep throat infection. Therefore, recent history of sore throat or fever is significant in identifying the possible cause of rheumatic fever in the child. Option A) “Has your child complained of back pain?” is incorrect because back pain is not a typical symptom associated with rheumatic fever. Option B) “Has your child complained of headaches?” is incorrect as headaches are also not specific to rheumatic fever and do not directly relate to its development. Option C) “Has your child had any nausea or vomiting?” is incorrect as these symptoms are not typically associated with rheumatic fever. Educationally, it is important for nurses to understand the link between streptococcal infections and the development of rheumatic fever in pediatric patients. By asking targeted questions related to potential preceding infections, nurses can gather crucial information to aid in the prompt diagnosis and management of rheumatic fever in children.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Supraventricular tachycardia (SVT). SVT is a common dysrhythmia in pediatric patients and is characterized by a rapid heart rate originating above the ventricles. The toddler's heart rate of 230 beats per minute, along with other symptoms such as difficulty waking up, low blood pressure, and prolonged capillary refill time, are indicative of SVT. Option A) Rapid atrial flutter is incorrect because atrial flutter typically presents with a regular but very fast atrial rate, not as rapid as seen in this case. Option C) Sinus bradycardia is also incorrect as it refers to a slow heart rate originating from the sinus node, which is not consistent with the toddler's presentation of a heart rate of 230 beats per minute. Option D) Rapid atrial fibrillation is incorrect because atrial fibrillation presents with an irregularly irregular heart rate pattern, unlike the regular rapid rate seen in this case. Educationally, understanding pediatric dysrhythmias is crucial for nurses caring for children, especially in acute care settings. Recognizing the signs and symptoms of SVT and other dysrhythmias promptly can lead to timely interventions and improved patient outcomes. Nurses need to be skilled in assessing vital signs, recognizing abnormal findings, and implementing appropriate interventions to manage dysrhythmias effectively in pediatric patients.

Correct Answer: B

Rationale: In the context of pharmacology and pediatric cardiovascular conditions, it is crucial to understand the cardiac manifestations associated with genetic conditions such as Trisomy 21 (Down syndrome). The correct answer is B) Congenital heart defect. Children with Trisomy 21 have a significantly higher risk of congenital heart defects compared to the general population. This association is well-documented, with up to 50% of children with Down syndrome having some form of congenital heart anomaly. These defects can range from atrial septal defects (ASD), ventricular septal defects (VSD), atrioventricular septal defects (AVSD), to more complex anomalies. Therefore, it is imperative to evaluate children with Trisomy 21 for these cardiac abnormalities early on to provide appropriate management and interventions. Now, let's analyze why the other options are incorrect: A) Systemic hypertension: While individuals with Down syndrome may develop hypertension later in life, it is not a primary cardiac manifestation associated with Trisomy 21 in pediatric patients. C) Hyperlipidemia: Although individuals with Down syndrome are at increased risk of developing hyperlipidemia, this is not a cardiac manifestation but rather a metabolic concern. D) Cardiomyopathy: Cardiomyopathy is not a commonly associated cardiac manifestation in children with Trisomy 21. Congenital heart defects are more prevalent in this population. In an educational context, understanding these cardiac manifestations in pediatric patients with genetic conditions like Trisomy 21 is essential for nurses and healthcare providers involved in their care. Early identification and appropriate management of congenital heart defects can significantly impact the long-term health outcomes and quality of life for these individuals.