Pediatrics Immunity

The nurse is caring for a 6-year-old with juvenile idiopathic arthritis. The mother states that she has trouble getting her daughter out of bed in the morning and believes the girl’s behavior is due to a desire to avoid going to school. What is the best advice by the nurse?

• Refer the girl to a psychologist for evaluation of school phobia related to chronic illness.

• Administer a warm bath every morning before school.

• Give the child her prescribed NSAIDs 30 minutes before getting out of bed.

• Allow her to stay in bed some mornings if she wants.

A 14-year-old with systemic lupus erythematosus wants to know how to care for her skin. What should the nurse teach this adolescent?

• Careful suntanning will give her skin an attractive color.

• No special skin care is needed.

• Use sunscreen daily to avoid rashes.

• Use makeup to camouflage the butterfly rash on her face.

The mother of a child with hypogammaglobulinemia reports that her child had a fever and slight chills with an intravenous gammaglobulin infusion last month. She wants to know what other course of treatment might be available. What is the best response by the nurse?

• Administration of acetaminophen or diphenhydramine prior to the next infusion may decrease the incidence of fever or chills.

• Giving the gammaglobulin intramuscularly is recommended to prevent a reaction.

• Talk to her physician or nurse practitioner about alternative medications that may be used to boost the gammaglobulin level in the blood.

• If the child is no longer experiencing frequent infections, then the IV infusions may not be necessary.

A 4-month-old infant born to an HIV-infected mother is going into foster care because the mother is too ill to care for the child. The foster mother wants to know if the infant is also infected. What is the best response by the nurse?

• “It’s too early to know; we have to wait until the infant has symptoms.”

• “Since the mother is so ill, it’s likely the child is also infected with HIV.”

• “The ELISA test is positive, so the child is definitely infected.”

• “The PCR test is positive; this indicates HIV infection, which may or may not progress to AIDS.”

A mother has received instructions about avoiding wheat and soy allergens. Which response by the mother would indicate that further education is needed?

• “I will not feed my child any breads made with wheat flour.”

• “I will allow my child to eat semolina pasta, the kind he loves.”

• “I will not feed my child shakes made with soy protein.”

• “I will read labels to be sure I am avoiding wheat and soy.”

What is the priority nursing intervention for the child recently admitted with Guillain–Barré syndrome?

• Perform range-of-motion exercises.

• Take temperature every 4 hours.

• Monitor respiratory status closely.

• Assess skin frequently.

The nurse is caring for a term newborn born to a mother with HIV infection. The infant weighs 6 lb 5 oz. The medication order reads: zidovudine 25 mg PO twice daily. Zidovudine is supplied as 50 mg/5 mL. How many milliliters will the nurse administer? Round to the nearest tenth.