Which of the following is a key difference between Hodgkin's lymphoma (HL) and Non-Hodgkin's lymphoma (NHL) in children?

A. Increasing the child’s intake of high-fat foods is incorrect as the primary concern in this scenario is acute respiratory compromise, not malnutrition. While high-calorie, high-fat diets are important for CF management to address nutritional deficits, this intervention does not immediately improve airway clearance or reduce respiratory symptoms.

B. Encouraging increased fluid intake is partially correct because hydration helps thin mucus, making it easier to clear. However, hydration alone is insufficient for managing acute airway obstruction, especially when the child has decreased breath sounds and increased respiratory secretions.

C. Administering inhaled corticosteroids is incorrect as these reduce airway inflammation over time but are not the first-line intervention for acute mucus obstruction or compromised ventilation. They are adjunctive therapy rather than the priority in acute management.

D. Initiating chest physiotherapy (CPT) is correct because CF causes thick, sticky mucus that obstructs the airways, leading to infection and decreased oxygenation. CPT, including percussion, vibration, and postural drainage, helps mobilize mucus, improve ventilation, prevent atelectasis, and reduce the risk of further respiratory complications. This is considered the priority nursing intervention for acute respiratory exacerbations in CF.

A. Barking cough and inspiratory stridor, especially at night is incorrect because this is characteristic of croup, a respiratory condition, not tetralogy of Fallot. Tetralogy of Fallot primarily affects cardiac blood flow, not the upper airway.

B. Bradycardia and hypotension following minor activity or mild stress is incorrect because children with tetralogy of Fallot typically develop tachycardia in response to hypoxia or stress, rather than bradycardia. Hypotension is not a hallmark sign unless there is shock or severe complications.

C. Cyanosis that worsens during crying or feeding, often relieved by squatting is correct because children with tetralogy of Fallot have right-to-left shunting due to the combination of ventricular septal defect, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy. This shunting reduces pulmonary blood flow, leading to cyanosis, which often becomes more pronounced during periods of increased oxygen demand, such as crying or feeding. Squatting increases systemic vascular resistance, temporarily reducing the shunt and improving oxygenation, which is known as a “Tet spell” relief maneuver.

D. Peripheral edema and hepatomegaly during exertion or prolonged play is incorrect because these signs are more typical of heart failure rather than tetralogy of Fallot in a child without chronic severe heart failure. Tetralogy of Fallot presents primarily with cyanosis and hypoxic spells.