A nurse is caring for a school-age child who has cystic fibrosis.

Exhibits

A nurse is reviewing the child's medical record. Which of the following medications should the nurse expect the provider to prescribe or reconcile from the child's home medication list? Select all that apply.

Water-soluble vitamins

Acetaminophen

Dornase alfa

Meperidine

Pancreatic lipase

Answer and Explanation

Correct Answer : A,C,E

Rationale:

A. Deficient levels of vitamins A, D, E, and K indicate malabsorption, necessitating supplementation with water-soluble vitamins to address nutritional deficiencies.

B. Acetaminophen is an analgesic and antipyretic that has no effect on the underlying cause of cystic fibrosis.

C. Dornase alfa (Pulmozyme) is a recombinant human deoxyribonuclease enzyme used in the management of cystic fibrosis to improve pulmonary function by reducing the viscosity of mucus in the airways.

D. Meperidine is an opioid analgesic that can cause respiratory depression and increase the risk of pulmonary complications.

E. Children with cystic fibrosis often have pancreatic insufficiency, leading to malabsorption of fats and fat-soluble vitamins. Pancreatic lipase supplements are necessary to aid in the digestion of fats.

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Correct Answer is D

Explanation

Rationale:

A. Scaly lesions on the inner thighs are not typically characteristic of scabies. Scabies lesions are often burrow-like and appear as small, raised, grayish-white or skin- colored lines, not scaly.

B. A rash with red macular lesions on the scalp is not characteristic of scabies.

Scabies lesions typically occur in areas with thin skin, such as the webs of fingers, wrists, elbows, axillary folds, waistline, buttocks, and genitalia.

C. A bull's eye edematous area on the groin is not characteristic of scabies. Scabies lesions usually present as small, raised, grayish-white or skin-colored lines or bumps, not as bull's eye patterns.

D. Maculopapular skin burrows on the hand are a classic manifestation of scabies.

Scabies mites burrow into the skin to lay eggs, causing raised, linear, erythematous, and excoriated lesions, which may appear as small papules or vesicles with a surrounding erythematous flare.

A. Creatinine 1.4 mg/dL (0.2 to 0.5 mg/dL) B. Creatinine 0.3 mg/dL (0.2 to 0.5 mg/dL) C. BUN 12 mg/dL (5 to 18 mg/dL) D. BUN 6 mg/dL (5 to 18 mg/dL)

Correct Answer is A

Explanation

Rationale:

A. An elevated creatinine level may indicate kidney dysfunction, which is a potential adverse effect of gentamicin therapy. It should be reported to the provider for further evaluation.

B. A creatinine level within the normal range is expected.

C. BUN within the normal range is expected.

D. BUN within the normal range is expected.

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A nurse is caring for a school-age child who has cystic fibrosis. Exhibits A nurse is reviewing the child's medical record. Which of the following medications should the nurse expect the provider to prescribe or reconcile from the child's home medication list? Select all that apply.

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Explanation

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A nurse is caring for a school-age child who has cystic fibrosis.

Exhibits

A nurse is reviewing the child's medical record. Which of the following medications should the nurse expect the provider to prescribe or reconcile from the child's home medication list? Select all that apply.