The parent of a school-age child reports that the child usually has
allergic rhinitis symptoms beginning each fall and that non-sedating
antihistamines
... [Show More] are only marginally effective, especially for nasal
obstruction symptoms. What will the primary care pediatric nurse
practitioner do?
a. a. Order an intranasal corticosteroid to begin 1 to 2 weeks prior to
pollen season.
b. b. Prescribe a decongestant medication as adjunct therapy during
pollen season.
c. c. Recommend adding diphenhydramine to the child’s regimen for
additional relief.
d. d. Suggest using an over-the-counter intranasal decongestant.
ANS: A
Intranasal corticosteroids are a key component in long-term therapy to
manage symptoms associated with AR. These should be begun 1 to 2 weeks
prior to the beginning of pollen season. Decongestants are not
recommended for long-term use because of side effects. Diphenhydramine
causes daytime drowsiness.
1. 2. The primary care pediatric nurse practitioner sees a child for follow-up
care after hospitalization for ARF. The child has polyarthritis but no cardiac
involvement. What will the nurse practitioner teach the family about
ongoing care for this child?
a. a. Aspirin is given for 2 weeks and then tapered to discontinue the
medication.
b. b. Prophylactic amoxicillin will need to be given for 5 years.
c. c. Steroids will be necessary to prevent development of heart
disease.
d. d. The child will need complete bedrest until all symptoms subside.
ANS: A
ASA is given for arthritis for 2 weeks and then will be tapered. Children with
ARF will need penicillin prophylaxis, not amoxicillin. Steroids are sometimes
used for symptomatic relief but do not prevent chronic heart disease. Bed
rest is indicated only when cardiac symptoms occur.
1. 3. A school-age child with asthma is seen for a well child checkup and, in
spite of “feeling fine,” has pronounced expiratory wheezes, decreased
breath sounds, and an FEV1 less than 70% of personal best. The primary
care pediatric nurse practitioner learns that the child’s parent administers
the daily medium-dose ICS but that the child is responsible for using the
SABA. A treatment of 4 puffs of a SABA in clinic results in marked
improvement in the child’s status. What will the nurse practitioner do?
a. a. Have the parent administer all of the child’s medications.
b. b. Increase the ICS medication to a high-dose preparation.
c. c. Reinforce teaching about the importance of using the SABA.
d. d. Teach the child and parent how to use home PEF monitoring. [Show Less]