Which of the following is appropriate in the treatment of bronchial foreign body?

Correct Answer: B

Rationale: In the treatment of bronchial foreign body in pediatric patients, the correct intervention is option B) Rigid open tube bronchoscopy. This procedure allows for direct visualization and removal of the foreign body, ensuring prompt relief and prevention of complications such as airway obstruction and respiratory distress. Option A) Flexible fiberoptic bronchoscopy may not provide adequate visualization and control needed for successful removal of larger or obstructive foreign bodies. Option C) Bronchodilators and postural drainage are interventions typically used for conditions like asthma or cystic fibrosis, not for the removal of foreign bodies. Option D) Foley catheter is not indicated for the removal of bronchial foreign bodies and its use can lead to complications. In an educational context, it is essential for nursing students to understand the appropriate interventions for pediatric respiratory distress, including the management of bronchial foreign bodies. Teaching the rationale behind the correct intervention helps students develop critical thinking skills and clinical reasoning, ensuring safe and effective patient care. It is crucial to emphasize the importance of prompt and accurate intervention in pediatric respiratory emergencies to prevent adverse outcomes.

Correct Answer: B

Rationale: In pediatric respiratory distress, particularly during an influenza episode, it is crucial to understand why babies are not allowed to eat. The correct answer, option B, states that the shorter and narrower airway of infants increases their chances of aspiration, making it unsafe for the child to eat during this time. Infants have underdeveloped airways, which can easily become obstructed, leading to aspiration of food or fluids. This can further compromise their respiratory function and worsen distress. Option A is incorrect because intravenous fluids do not address the risk of aspiration associated with eating during respiratory distress. Option C is incorrect as it does not directly address the respiratory concerns in a baby with influenza. Option D is incorrect because while nasal congestion can affect feeding, the main concern in this scenario is the risk of aspiration due to the infant's anatomy. Educationally, this rationale highlights the importance of understanding the physiological differences in pediatric patients that make them more vulnerable to respiratory complications. It emphasizes the need for safe feeding practices and respiratory support during episodes of distress to prevent further complications and promote optimal outcomes for the infant.

Correct Answer: B

Rationale: The correct answer is B) Twenty-four hours after the first dose of antibiotics. In the case of strep throat, caused by group A Streptococcus bacteria, it is important for the child to stay home and rest until they have been on antibiotics for at least 24 hours. This is crucial to prevent the spread of the infection to other children at school. Antibiotics help to treat the bacterial infection and reduce the contagiousness of the child. Option A) Forty-eight hours after the first documented normal temperature may not be sufficient as the child could still be contagious even if their temperature has normalized. Option C) Forty-eight hours after the first dose of antibiotics is too long to keep the child away from school if they are no longer contagious after 24 hours of antibiotic treatment. Option D) Twenty-four hours after the first documented normal temperature does not guarantee that the strep throat infection has been adequately treated with antibiotics, which are the primary treatment for this condition. Educationally, understanding the appropriate timing for a child to return to school after being diagnosed with strep throat is important for nurses working in school settings to prevent the spread of infections and ensure the well-being of all students. It also highlights the significance of completing the full course of antibiotics as prescribed by healthcare providers.

Correct Answer: A

Rationale: In pediatric nursing, understanding the infectious period of influenza is crucial for implementing appropriate infection control measures. The correct answer is A) Twenty-four hours before and after the onset of symptoms. This is because individuals, including children, infected with influenza virus are most contagious during the period just before and after symptoms appear. This is when the viral load in respiratory secretions is highest, posing a significant risk of transmission to others. Option B) Twenty-four hours after the onset of symptoms is incorrect because it underestimates the contagious period. By the time symptoms appear, the child has likely already been shedding the virus and infecting others. Option C) One week after the onset of symptoms is incorrect as the child's infectious period typically diminishes after a few days post-symptom onset, although viral shedding can continue for a bit longer in some cases. Option D) One week before the onset of symptoms is incorrect as individuals are not infectious before they contract the virus and start showing symptoms. Educationally, this question highlights the importance of understanding the infectious periods of common childhood illnesses like influenza to prevent the spread of infections in healthcare settings, schools, and communities. Nurses need to be vigilant in their infection control practices, especially during peak infectious periods, to protect vulnerable pediatric populations.

Correct Answer: C

Rationale: In the context of pediatric respiratory distress due to pneumonia, the 15-year-old with vomiting for 3 days and a fever of 38.5°C (101.3°F) would benefit most from hospitalization. This choice is correct because persistent vomiting can lead to dehydration, which can worsen respiratory distress. Additionally, the combination of vomiting and fever indicates a more severe illness that may require closer monitoring and intravenous fluid administration in a hospital setting. Option A is incorrect because while cough, coarse breath sounds, and poor sleep are concerning symptoms, they do not indicate the same level of acuity as dehydration from persistent vomiting. Option B, a 14-year-old with fever, rapid breathing, and decreased appetite, is also concerning but does not present with the added complication of persistent vomiting. Option D, a 16-year-old with cough, chills, fever, and wheezing, may have a viral respiratory infection rather than pneumonia, which typically presents with crackles rather than wheezing. In an educational context, it is important for nurses to understand the nuances of pediatric respiratory distress presentations to make appropriate clinical decisions regarding hospitalization. Recognizing the need for hospitalization based on specific symptoms can help prevent complications and improve outcomes in pediatric patients with pneumonia.