When planning care for a 6-year-old child with cystic fibrosis, which nursing intervention should be prioritized?
Provide nutritional counseling to parents.
Perform chest physiotherapy to clear the airway.
Administer pancreatic enzymes with meals.
Administer influenza vaccine.
The Correct Answer is B
The clinical management of cystic fibrosis requires addressing multisystem impairments. This scenario focuses on the prioritization of nursing interventions based on the urgency of physiological needs. Knowledge of airway clearance techniques, enzyme replacement, and preventive care is necessary to identify the most critical action.
Choice A rationale
Nutrition is vital as the normal range for BMI should be maintained above the 50th percentile. Malabsorption occurs due to mucus blocking ducts, but nutritional counseling is a long-term goal rather than an immediate physiological priority.
Choice B rationale
Maintaining airway patency is the primary concern in cystic fibrosis due to viscous secretions. Chest physiotherapy facilitates mucus mobilization and prevents respiratory failure. Airway management always takes precedence over other interventions in the acute care setting.
Choice C rationale
Pancreatic enzymes are required to manage exocrine insufficiency and promote absorption of fats. While necessary for growth, this intervention follows airway stabilization. Lack of enzymes leads to steatorrhea but is not immediately life-threatening like airway obstruction.
Choice D rationale
Prevention of respiratory infections is important, as influenza can cause severe exacerbations. However, immunization is a secondary prevention strategy. It does not address the immediate mechanical need to clear obstructive mucus from the pulmonary system.
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Related Questions
Correct Answer is B
Explanation
Celiac disease is an autoimmune enteropathy triggered by the ingestion of gluten in genetically predisposed individuals. Clinical management requires strict adherence to a gluten-free diet, necessitates the identification of hidden gluten sources in processed wheat, barley, and rye products.
Choice A rationale
Potatoes are naturally gluten-free tubers containing complex carbohydrates. They do not contain the gliadin proteins that trigger the autoimmune inflammatory response in the small intestine, making them a safe starch replacement for celiac patients.
Choice B rationale
Graham crackers are manufactured using wheat flour, which contains gluten. In celiac disease, gluten ingestion leads to villous atrophy in the small intestine, causing malabsorption, steatorrhea, and nutritional deficiencies, necessitating total avoidance of wheat-based snacks.
Choice C rationale
Wild rice is a gluten-free grain that is safe for patients with celiac disease. Despite its name, it is a grass seed unrelated to wheat, providing essential fiber and nutrients without damaging the intestinal mucosa.
Choice D rationale
Canned pears are typically processed with water or sugar syrup and are naturally gluten-free. Unless cross-contamination occurs during packaging, fruit provides safe vitamins and minerals without containing the harmful proteins found in wheat, barley, or rye.
Correct Answer is B
Explanation
This scenario requires the application of pediatric injury prevention and safety education for the toddler developmental stage. Understanding leading causes of mortality versus morbidity is essential to distinguish between fatal risks and common household hazards that necessitate environmental modifications for injury reduction.
Choice A rationale
While drowning is a significant risk, motor vehicle accidents typically remain the primary cause of accidental death in toddlers. Scientific data emphasizes car seat safety and road hazards as the leading threats to life during this period.
Choice B rationale
Toddlers possess a high center of gravity and limited coordination, making them susceptible to drowning in shallow water. Submersion in small volumes, such as toilet water or buckets, can quickly lead to hypoxia and cerebral edema.
Choice C rationale
Toddlers experience frequent falls, but their bones are often more pliable and less prone to fractures than older children. Helmet use is primarily indicated for wheeled activities rather than general daily ambulation within the home.
Choice D rationale
While storage in cabinets is necessary, toddlers are curious and physically capable of opening many enclosures. Safety education emphasizes that cabinets must be locked or latched because simple placement does not provide adequate protection against ingestion.
Choice E rationale
Stairs represent a significant risk for falls and trauma, but they are not the leading cause of injury-related death. Developmentally, children usually master stair climbing with supervision well before the age of four years.
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