What is the nurse’s best response to a mother whose son is diagnosed with epiglottitis?

Correct Answer: D

Rationale: The correct answer is D) "Epiglottitis is rapidly progressive; you could not have predicted his symptoms would worsen so quickly." This response is the best because it provides the mother with accurate information about the nature of epiglottitis. Epiglottitis is a medical emergency that can rapidly progress and compromise the airway, leading to respiratory distress. By acknowledging the rapid progression of the condition, the nurse can help the mother understand the seriousness of the situation and the need for immediate medical intervention. Option A is incorrect because it dismisses the severity of epiglottitis in children and may lead the mother to underestimate the condition. Option B, while emphasizing early evaluation, does not specifically address the rapid progression of epiglottitis. Option C is misleading as epiglottitis is actually an acute condition that can progress rapidly rather than slowly. In an educational context, it is crucial for nurses to have a solid understanding of pediatric respiratory conditions like epiglottitis. By providing accurate information and support to parents, nurses can help ensure timely interventions and better outcomes for pediatric patients. This scenario underscores the importance of clear communication with parents about the nature of their child's condition and the need for prompt medical attention.

Correct Answer: A

Rationale: In the context of pediatric respiratory nursing, the correct answer, option A, is when the first chest physiotherapy (CPT) should be performed for a 4-month-old with cystic fibrosis (CF). Performing CPT before feeding the child breakfast helps in clearing the airways of mucus and promoting effective breathing. This timing ensures that the child's airways are clear before any potential risk of aspiration during feeding, which is crucial for infants with CF who are prone to respiratory complications. Option B, after deep suctioning each morning, is incorrect because CPT should be done before feeding to prevent complications during feeding. Option C, thirty minutes after feeding, is incorrect as it does not address the immediate need to clear the airways for optimal respiratory function. Option D, performing CPT only when the child has congestion or coughing, is incorrect as CPT is a proactive treatment to prevent respiratory issues in CF patients rather than a reactive measure. Educationally, understanding the timing and importance of CPT in pediatric patients with CF is crucial for nursing professionals to provide optimal care. By performing CPT before feeding, nurses can help prevent respiratory complications, improve airway clearance, and promote better respiratory health outcomes for these vulnerable patients.

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.