A nurse is reinforcing teaching with a parent of a child who has a new prescription for a budesonide inhaler. Which of the following adverse reactions should the nurse include in the teaching?
Short stature
Weight loss
Oral candidiasis
Peptic ulcer
The Correct Answer is C
A. Short stature: Short stature is not a common adverse effect of budesonide when used as an inhaler. However, long-term use of inhaled corticosteroids in children may have a small effect on growth, but it is not a primary concern with budesonide.
B. Weight loss: Weight loss is not associated with the use of an inhaled corticosteroid like budesonide. Weight gain or fluid retention may be more common with systemic steroids, but this is less of a concern with inhaled forms.
C. Oral candidiasis: Oral candidiasis (thrush) is a known side effect of inhaled corticosteroids, including budesonide. This occurs due to the medication's impact on the oral mucosa, which can promote fungal growth. To reduce the risk, the child should rinse their mouth after using the inhaler.
D. Peptic ulcer: Peptic ulcers are more commonly associated with systemic corticosteroids, not with inhaled corticosteroids like budesonide. Although systemic absorption can occur, the risk for ulcers is significantly lower with inhaled forms compared to oral or injected steroids.
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Related Questions
Correct Answer is B
Explanation
A. Promoting nutrition: While nutrition is important, preventing infections is more urgent in a preschooler with leukemia. Leukemia and its treatments, such as chemotherapy, can significantly weaken the immune system, making the child more susceptible to infections.
B. Preventing infections: Preventing infections is critical for children with leukemia because their immune systems are compromised, either by the disease itself or by treatments like chemotherapy. Educating the guardians on how to prevent infections (e.g., hand hygiene, avoiding crowds, keeping the environment clean) is crucial to avoid serious complications.
C. Supporting psychological wellness: While psychological support is important, the priority for a preschooler with leukemia is to focus on preventing infections and ensuring their physical well-being, as infections can lead to severe consequences.
D. Managing mucosal ulcerations: Mucosal ulcerations can be a concern for children undergoing cancer treatment, but preventing infections is a more immediate and potentially life-saving priority. Once infections are controlled, mucosal ulcerations can also be addressed.
Correct Answer is D
Explanation
A. Position the child sitting with their buttocks at the edge of the table: This position is not appropriate for bone marrow aspiration. It does not provide adequate access to the iliac crest, which is the common site for bone marrow collection in children.
B. Position the child side-lying to expose the vertebrae: The vertebrae are not typically used for bone marrow aspiration. The iliac crest (the top of the hip bone) is the preferred site, and side-lying does not expose this area appropriately for the procedure.
C. Place the child supine with legs flexed outward into a frog-like position: This position is commonly used for procedures such as abdominal or pelvic examinations but does not provide the best access for bone marrow aspiration from the iliac crest.
D. Place the child in prone position to expose the posterior iliac crest: The prone position with the back exposed allows the posterior iliac crest to be properly accessed for bone marrow aspiration. This is the correct position for the procedure in children.
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