Which of the following is an adverse reaction to topical nasal steroid?

Choice A rationale

While a complete blood count (CBC) is an essential lab value for monitoring many conditions and potential side effects, it is not the primary concern when administering high doses of azithromycin, especially with co-administration of acetaminophen. The focus should be on liver function.

Choice B rationale

Urinalysis is useful in diagnosing and monitoring various conditions but is not directly relevant to monitoring the side effects of azithromycin and acetaminophen. These medications do not typically cause urinary abnormalities that would necessitate frequent urinalysis.

Choice C rationale

Electrolytes are not directly affected by azithromycin and acetaminophen use. Although monitoring electrolytes can be essential in broader contexts, these specific medications do not primarily impact electrolyte balance requiring focused monitoring.

Choice D rationale

Liver enzymes are the key lab values to monitor when administering high doses of azithromycin and acetaminophen. Both medications are metabolized by the liver and can cause hepatotoxicity. Monitoring liver enzymes helps in detecting early signs of liver damage and preventing further complications.

Choice A rationale

Using an “ouch” scale, such as the Wong-Baker FACES Pain Rating Scale, is appropriate for young children. It allows them to express their pain intensity in a way that is understandable and relatable to their age group.

Choice B rationale

Encouraging a six-year-old to request pain medication may not be effective, as they might not understand when they need it or might be reluctant to ask.

Choice C rationale

Waiting to administer pain medication until the child begins to cry can delay pain relief, leading to unnecessary discomfort and anxiety.

Choice D rationale

Asking a young child to rate their pain on a scale of 1 to 10 might be confusing and less effective than using a more child-friendly method like the “ouch” scale.