For the same child weighing 36 kg in moderate dehydration, now calculate the volume of ORS they should receive every 15 minutes. (Do not enter units)
Which foods should a child with celiac disease include in their diet?

Choice A reason:

Rye and oats: Rye contains gluten, which must be avoided by individuals with celiac disease. Oats, while naturally gluten-free, can often be contaminated with gluten during processing. Therefore, they should be introduced cautiously and only if labeled gluten-free.

Choice B Reason:

Wheat and corn: Wheat is a major source of gluten and must be strictly avoided by those with celiac disease. Corn, on the other hand, is naturally gluten-free and safe for consumption. However, since wheat is included in this option, it is not suitable for a gluten-free diet.

Choice C Reason:

Rice and soy: Both rice and soy are naturally gluten-free and safe for individuals with celiac disease. They are excellent alternatives to gluten-containing grains and provide essential nutrients.

Choice D Reason:

Barley and millet grain: Barley contains gluten and must be avoided by those with celiac disease. Millet is naturally gluten-free and safe for consumption. However, since barley is included in this option, it is not suitable for a gluten-free diet.

Choice A reason:

Opioid analgesics are not given as a last resort solely because of the threat of addiction. While the risk of addiction is a concern, opioids are often necessary for managing severe pain, especially in conditions like sickle cell anemia. The American Society of Hematology guidelines emphasize the importance of effective pain management in sickle cell disease, which often includes the use of opioids. The goal is to manage pain effectively while monitoring for signs of misuse or addiction.

Choice B reason:

Opioid analgesics are often ordered and are usually needed for managing severe pain in patients with sickle cell anemia. Pain episodes in sickle cell disease can be extremely severe and debilitating, requiring potent analgesics like morphine for relief. The management of acute vaso-occlusive pain in sickle cell disease often necessitates the use of opioids to provide adequate pain control.

Choice C reason:

Opioid analgesics, when medically indicated and used under proper medical supervision, rarely cause addiction. The risk of addiction is significantly lower when opioids are used appropriately for pain management in a controlled medical setting. The Mayo Clinic highlights that while opioids have addictive properties, their medical use for pain relief, especially in acute settings, is generally safe when monitored by healthcare professionals.

Choice D reason:

Opioid analgesics are not used only if other measures, such as ice packs, are ineffective. While non-pharmacological measures can be part of pain management, opioids are often necessary for managing severe pain episodes in sickle cell disease. The use of opioids is based on the severity of the pain and the clinical judgment of the healthcare provider.