A nurse is caring for a toddler who has acute laryngotracheobronchitis and has been placed in a cool mist tent. Which of the following findings indicates that the treatment has been effective?

Choice A: A 10-year-old child who has sickle cell anemia and reports severe chest pain should be assessed first, as this is a sign of acute chest syndrome, which is a life-threatening complication of sickle cell disease. Acute chest syndrome occurs when sickle-shaped red blood cells block the blood flow to the lungs, causing hypoxia, inflammation, and infection. Acute chest syndrome can lead to respiratory failure, pulmonary hypertension, or stroke.

Choice B: A 7-year-old child who has diabetes insipidus and a urine specific gravity of 1.016 should be assessed second, as this is a sign of dehydration, which is a common complication of diabetes insipidus. Diabetes insipidus is a condition in which the body does not produce enough antidiuretic hormone (ADH) or does not respond to it properly, resulting in excessive urination and thirst. Dehydration can cause electrolyte imbalance, hypotension, or shock.

Choice C: A 4-year-old child who has asthma and an O2 sat of 97% should be assessed third, as this is a sign of adequate oxygenation, which is a desired outcome of asthma management. Asthma is a condition in which the airways become inflamed, narrow, and produce excess mucus, causing difficulty breathing, wheezing, coughing, or chest tightness. Asthma can be triggered by allergens, irritants, exercise, or infections.

Choice D: A 1-year-old toddler who has roseola and a temperature of 39°C/102.2°F should be assessed last, as this is a sign of a mild viral infection, which is self-limiting and usually resolves within a week. Roseola is a common childhood illness that causes a high fever followed by a pink rash on the trunk, face, and limbs. Roseola can also cause irritability, swollen lymph nodes, or mild diarrhea.

Choice A: Hepatitis B (HepB) vaccine is not contraindicated for a child who has an allergy to eggs, as it does not contain any egg protein or other components that can cause an allergic reaction. Hep B vaccine is recommended for all infants at birth and children up to 18 years of age.

Choice B: Inactivated poliovirus (IPV) vaccine is not contraindicated for a child who has an allergy to eggs, as it does not contain any egg protein or other components that can cause an allergic reaction. IPV vaccine is recommended for all children at ages 2, 4, and 6 to 18 months and at ages 4 to 6 years.

Choice C: Influenza, live attenuated (LAIV) vaccine is contraindicated for a child who has an allergy to eggs, as it contains egg protein that can cause an allergic reaction. LAIV vaccine is a nasal spray that contains live but weakened influenza viruses. LAIV vaccine is recommended for healthy children aged 2 years and older who do not have chronic medical conditions or other contraindications.

Choice D: Haemophilus influenzae type b (Hib) vaccine is not contraindicated for a child who has an allergy to eggs, as it does not contain any egg protein or other components that can cause an allergic reaction. Hib vaccine is recommended for all children at ages 2, 4, and 6 months and at ages 12 to 15 months.