A 9-month-old infant with a diagnosis of gastroesophageal reflux (GER) is being discharged from the hospital.
The nurse is educating the parents about signs of possible complications related to GER.
Which of the following signs should the parents report immediately to the pediatrician?
Irritability after feedings.
A slight decrease in appetite.
Coughing or wheezing during sleep.
Occasional spitting up after feedings.
The Correct Answer is C
Choice A rationale
Irritability after feedings can be a common symptom of GER due to stomach acid refluxing into the esophagus and causing discomfort. While it should be reported, it is not necessarily an immediate sign of a serious complication.
Choice B rationale
A slight decrease in appetite can occur with GER due to discomfort or a learned aversion to feeding. While it warrants monitoring, it is not typically an immediate red flag for severe complications.
Choice C rationale
Coughing or wheezing during sleep can indicate aspiration of gastric contents into the airway due to severe GER. Aspiration can lead to respiratory complications such as pneumonia, making this a serious sign that requires immediate medical attention.
Choice D rationale
Occasional spitting up after feedings is a common manifestation of GER in infants and is often physiological. While frequent or forceful spitting up should be monitored, occasional spitting up in a 9-month-old with known GER is not necessarily a sign of a serious complication requiring immediate reporting.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition characterized by pruritus (itching), erythema (redness), and scaling. Topical corticosteroids are the first-line treatment due to their potent anti-inflammatory and immunosuppressive properties, which help to reduce the inflammatory response in the skin and alleviate itching.
Choice B rationale
Psoriasis is a chronic autoimmune skin disorder characterized by thickened, scaly plaques. Topical calcineurin inhibitors are used to treat psoriasis by suppressing the activity of T-cells, which are involved in the inflammatory process. The presentation of an itchy rash as the primary finding is less consistent with typical psoriasis.
Choice C rationale
Contact dermatitis is an inflammatory skin reaction resulting from direct contact with an irritant or allergen, often presenting with redness, swelling, and vesicles in addition to itching. While topical antihistamines can help with itching associated with allergic reactions, topical corticosteroids are generally more effective for managing the inflammation in contact dermatitis.
Choice D rationale
Tinea corporis, or ringworm, is a fungal infection of the skin characterized by circular, raised, scaly patches with central clearing. Topical antifungals are the appropriate treatment for tinea infections as they inhibit the growth and reproduction of the dermatophyte fungi causing the infection.
Correct Answer is C
Explanation
Choice A rationale
Limiting fluid intake is generally not indicated for atopic dermatitis unless there is a specific comorbid condition warranting fluid restriction. Maintaining adequate hydration is usually encouraged for overall skin health.
Choice B rationale
Promoting peeling of dead skin is not a primary goal in managing atopic dermatitis. The focus is on reducing inflammation, relieving itching, and maintaining skin hydration and barrier function, not necessarily on exfoliation.
Choice C rationale
Maintaining skin integrity and preventing infection are the most important goals in the care of a child with atopic dermatitis. The chronic inflammation and itching can lead to skin breakdown, increasing the risk of secondary bacterial or viral infections. Nursing interventions focus on gentle skin care, emollients, and managing itching.
Choice D rationale
Alcohol-based lotions should be avoided in children with atopic dermatitis as alcohol can dry and irritate the skin, exacerbating the condition and impairing skin integrity. Emollients that are fragrance-free and hypoallergenic are preferred to maintain skin hydration.
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