When Sarah was 4 months old and had already been diagnosed with cystic fibrosis, her parents were learning about interventions they needed to incorporate into her daily routine to promote her best help. One of the questions they had was when to begin Sarah's first chest physiotherapy (CPT) of each day. The nurse's best response would be:

Correct Answer: C

Rationale: The correct answer is "C) Thirty minutes after feeding your child breakfast." This timing is important in pediatric cystic fibrosis management as it allows for digestion to occur, reducing the risk of regurgitation or aspiration during chest physiotherapy (CPT). Performing CPT too close to feeding can lead to discomfort or vomiting. Option A is incorrect because performing CPT before feeding may cause discomfort due to pressure on the full stomach. Option B is incorrect as deep-suctioning is a separate intervention and not directly related to timing of CPT. Option D is incorrect as CPT is a preventive maintenance therapy in cystic fibrosis, not solely for treating symptoms like congestion or coughing. In an educational context, understanding the timing and rationale behind interventions in pediatric cystic fibrosis management is crucial for optimal health outcomes. Educating parents on the proper timing of CPT helps them integrate it effectively into their child's daily routine, promoting airway clearance and overall respiratory health.

Correct Answer: A

Rationale: In the scenario presented, the correct next best treatment option is A) IV magnesium sulphate. IV magnesium sulfate is indicated in cases of severe acute asthma exacerbation that is unresponsive to initial bronchodilator therapy. Magnesium sulfate acts as a bronchodilator and has been shown to help relax smooth muscle in the airways, thereby improving airflow. IV epinephrine (option B) is not recommended in the treatment of acute asthma exacerbation as it can lead to adverse cardiovascular effects and is not considered a first-line therapy. IM epinephrine (option C) is also not recommended due to the risk of systemic side effects and potential for delayed response compared to other treatment options. IV aminophylline (option D) is no longer considered a first-line treatment for acute asthma exacerbation due to its narrow therapeutic window, potential for toxicity, and availability of safer and more effective treatment options. Educationally, understanding the appropriate management of acute asthma exacerbation in pediatric patients is crucial for healthcare providers working in emergency departments or pediatric settings. Knowing when to escalate treatment to IV magnesium sulfate in cases of severe exacerbation is essential for improving patient outcomes and preventing complications. It is important to stay updated on current guidelines and evidence-based practices to provide optimal care for pediatric patients with respiratory conditions.

Correct Answer: B

Rationale: In the context of pediatric nursing, it is crucial to understand the appropriate treatments for common cold in children. The correct answer, B) First generation antihistamine, is the exception among the options provided. While antihistamines are commonly used in adults for cold symptoms, they are not recommended for young children due to the risk of side effects such as sedation and paradoxical excitation. A) Vitamin C is often used as a supplement to boost the immune system, although its efficacy in preventing or treating the common cold is debated. Some studies suggest it may reduce the duration of cold symptoms. C) Topical or oral adrenergic agents are used for symptomatic relief of nasal congestion in children with colds. They work by constricting blood vessels in the nasal passages, reducing swelling and congestion. D) Ipratropium bromide is a medication used to alleviate symptoms of runny nose caused by colds or allergies by decreasing nasal discharge. Educationally, it is important for pediatric nurses to be aware of the appropriate treatment options for common cold in children to ensure safe and effective care. Understanding the rationale behind each treatment option helps in making informed clinical decisions and promoting the well-being of pediatric patients.

Correct Answer: A

Rationale: The correct answer that needs further teaching is option A, "The sequence of each stage is unpredictable and varies from person to person." This statement is inaccurate because the sequence of growth and development stages is actually quite predictable and follows a general pattern across individuals. Understanding the typical sequence of growth and development stages is crucial for healthcare providers to identify any deviations or delays that may indicate underlying health issues or developmental concerns in children. Option B, "Growth is the quantitative change while development is a qualitative maturation of systems," is a correct statement that distinguishes between the concepts of growth and development accurately. Growth refers to physical changes in size and structure, while development encompasses the advancement and refinement of skills, behaviors, and functions. Option C, "Growth and development occurs in a cephalocaudal and proximo-distal pattern," is also correct. This statement describes the directional pattern in which growth and development progress, with changes typically occurring from head to toe (cephalocaudal) and from the center of the body outward (proximo-distal). Option D, "Growth and development are continuous influenced by maturational, environmental, and genetic factors," is a correct statement highlighting the multifaceted nature of factors influencing growth and development in children. These factors interact dynamically to shape a child's growth trajectory and developmental outcomes. In an educational context, clarifying misconceptions about growth and development is essential for nursing students to accurately assess and monitor pediatric patients. By understanding the typical patterns and factors influencing growth and development, healthcare providers can effectively promote optimal health and well-being in children. It is important to reinforce accurate knowledge to ensure competent and comprehensive care for pediatric patients.

Correct Answer: C

Rationale: The most appropriate nursing action in this scenario is to suggest that the parents ignore the child's behavior (Option C). Ignoring temper tantrums can often be an effective way to extinguish the behavior because it removes the reinforcement the child may be seeking through attention. By not giving in to the tantrum, the child learns that this behavior will not lead to the desired outcome of attention or control. Option A is not the best choice because at 2 years old, Nicole may not fully comprehend complex rules. Leaving Nicole alone in her bedroom (Option B) could lead to feelings of abandonment and isolation, which may exacerbate the tantrum. Explaining that Nicole is jealous of the new baby (Option D) may not address the immediate behavior and could inadvertently reinforce the tantrum by giving it a label and attention. In an educational context, understanding toddler behavior and development is crucial for nurses working with pediatric populations. By recognizing typical behaviors like temper tantrums as part of normal development, nurses can provide appropriate guidance to parents and caregivers on how to effectively manage and respond to these behaviors. Ignoring tantrums can help children learn more adaptive ways to cope with frustration and communicate their needs.