A nurse is preparing to administer a vaccine to a toddler.
Which of the following actions should the nurse plan to take?

Choice A rationale

Chocolate malt often contains barley malt, which contains gluten. For children with celiac disease, gluten can damage the small intestine, leading to malabsorption of nutrients. Therefore, giving a chocolate malt could trigger symptoms like abdominal pain, diarrhea, or growth problems.

Choice B rationale

Barley-based breakfast cereal is not appropriate for a child with celiac disease. Barley contains gluten, which must be avoided entirely by those with this condition to prevent damage to the intestinal lining and associated symptoms.

Choice C rationale

Rye bread is another source of gluten and is inappropriate for children with celiac disease. Consuming rye bread could result in similar adverse reactions as those caused by wheat and barley, such as villous atrophy in the small intestine.

Choice D rationale

Rice pudding is gluten-free, making it a safe dessert option for a child with celiac disease. Rice is a suitable carbohydrate source that doesn’t contain gluten, thus preventing any harm to the child's intestines or triggering of symptoms.

Choice A rationale

Peanut allergies are typically lifelong, and it is uncommon for children to outgrow them. Research indicates that only about 20% of children with peanut allergies will outgrow them over time. Hence, it is important for the guardian to be prepared for managing the allergy throughout the child's life.

Choice B rationale

While it is essential for the child to avoid peanuts, advising against all types of nuts is not necessary unless the child has been diagnosed with allergies to other nuts as well. Cross-reactivity is possible, but it is not a given for all nut types.

Choice C rationale

An epinephrine auto-injector is a critical tool for managing severe allergic reactions (anaphylaxis) in children with peanut allergies. Immediate administration of epinephrine can be life-saving, and carrying an auto-injector ensures that the child is prepared in case of accidental exposure to peanuts.

Choice D rationale

The severity of peanut allergies typically remains consistent over time, though the risk of severe reactions upon exposure persists. The focus should be on prevention and preparedness rather than expecting an increase in severity with prolonged exposure.