A child with secondary enuresis who reports of dysuria or urgency should be evaluated for what condition? (Select all that apply.)

The correct answer is choice A: Anaphylactic shock.

Choice A rationale:

Anaphylactic shock is the correct answer. Anaphylactic shock is a severe and potentially life-threatening allergic reaction that causes massive vasodilation, capillary leakage, and bronchoconstriction. It can occur rapidly after exposure to an allergen such as certain foods, insect stings, medications, or latex. The release of histamine and other inflammatory mediators leads to systemic vasodilation and increased permeability of blood vessels, resulting in a sudden drop in blood pressure and compromised organ perfusion.

Choice B rationale:

Cardiogenic shock is characterized by inadequate cardiac output due to severe heart dysfunction. It is typically caused by conditions like myocardial infarction, heart failure, or other cardiac issues. While allergic reactions can potentially affect the cardiovascular system, the symptoms described in the question are more indicative of anaphylactic shock.

Choice C rationale:

Neurogenic shock results from disruption of sympathetic nervous system control over blood vessel tone, often due to spinal cord injury or severe emotional distress. This leads to widespread vasodilation and a sudden drop in blood pressure. While it can cause hemodynamic instability, it doesn't specifically involve the hypersensitivity reaction and capillary leaks associated with anaphylactic shock.

Choice D rationale:

Hypovolemic shock is caused by a significant loss of blood volume or bodily fluids, leading to decreased intravascular volume and subsequent inadequate tissue perfusion. This shock type is not directly related to a hypersensitivity reaction or capillary leakage caused by allergic responses. 2 / 2

The correct answers are choices A, D, and E. Unequal waist angles, an uneven hemline, and asymmetry of the shoulders.

Choice A rationale:

Unequal waist angles can be an indication of scoliosis, a condition characterized by abnormal lateral curvature of the spine. When the spine curves, it can cause one side of the waist to appear higher than the other, leading to unequal waist angles. This is a key physical finding in scoliosis assessment.

Choice B rationale:

Complaints of a sore back are a non-specific symptom and may not directly indicate scoliosis. While scoliosis can sometimes cause discomfort or pain, it's not the primary assessment finding that the nurse should expect to observe.

Choice C rationale:

Inability to bend at the waist is not a typical assessment finding of scoliosis. Scoliosis primarily involves the lateral curvature of the spine, which can lead to visible asymmetry and postural changes rather than restrictions in bending.

Choice D rationale:

An uneven hemline can be a sign of scoliosis. When the spine curves, it can cause the hips and shoulders to become misaligned, leading to changes in the alignment of clothing and accessories, such as an uneven hemline.

Choice E rationale:

Asymmetry of the shoulders is a common manifestation of scoliosis. One shoulder may appear higher than the other due to the lateral curvature of the spine. This asymmetry is often more noticeable when the child is viewed from behind.