A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. While an airway is being established, what medication should the nurse prepare for immediate administration?

The correct answer is choice D: Low in phosphorus.

Choice A rationale:

Supplemented with vitamins A, E, and K is not the characteristic of the diet for a child with chronic renal failure. While vitamin supplementation might be necessary in some cases, the primary dietary considerations in chronic renal failure are related to managing electrolyte imbalances, fluid retention, and waste buildup due to compromised kidney function.

Choice B rationale:

High in protein is not the recommended characteristic of the diet for a child with chronic renal failure. Kidneys affected by chronic renal failure have a reduced ability to filter and excrete waste products from protein metabolism. Excessive protein intake can lead to the accumulation of nitrogenous waste products, potentially worsening the condition and contributing to uremia.

Choice C rationale:

Low in vitamin D is not the primary characteristic of the diet for a child with chronic renal failure. Vitamin D metabolism can be affected by kidney dysfunction, but the focus of the diet in chronic renal failure is primarily on managing electrolyte levels, particularly phosphorus and potassium, as well as controlling fluid intake.

Choice D rationale:

Low in phosphorus is the correct characteristic of the diet for a child with chronic renal failure. Impaired kidney function in chronic renal failure leads to difficulty in excreting phosphorus, which can result in elevated blood phosphorus levels. High phosphorus levels can contribute to bone and mineral disorders and cardiovascular complications. Therefore, a diet low in phosphorus is crucial to prevent these complications and manage the progression of the disease.

The correct answer is choice A: Administer pancreatic enzymes between meals if at all possible.

Choice A rationale:

Administer pancreatic enzymes between meals if at all possible. This is the correct choice. When educating the parents and child with cystic fibrosis about the administration of pancreatic enzymes, it's important to emphasize that these enzymes should be given between meals whenever feasible. Administering them between meals, when the stomach is less acidic and less likely to release the enzymes prematurely, ensures optimal digestion of food and absorption of nutrients. This approach aligns with the physiological need to supplement pancreatic enzyme function due to the inadequate natural enzyme production in cystic fibrosis.

Choice B rationale:

Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal. This choice is a valid option for administering pancreatic enzymes. While it's true that the enzymes can be taken either by swallowing the capsules whole or by opening them and sprinkling the contents on a small amount of food at the start of a meal, this method can vary based on individual preferences and abilities. However, the primary focus should be on timing (between meals) to achieve the best enzymatic action.

Choice C rationale:

Do not administer pancreatic enzymes if the child is receiving antibiotics. This statement is not accurate. There is no general contraindication to administering pancreatic enzymes while a child is on antibiotics. However, it's important for the healthcare provider to be aware of all the medications the child is taking to ensure there are no potential drug interactions or effects on absorption. Always consult with the healthcare team before adjusting the administration of any medication.

Choice D rationale:

Decrease the dose of pancreatic enzymes if the child is having frequent, bulky stools. This statement is not consistent with typical practice. If a child is experiencing frequent, bulky stools, it may actually indicate that the pancreatic enzyme dosage needs adjustment (increasing the dose rather than decreasing). Bulky stools can suggest poor digestion and absorption, which might require more enzymes to properly break down nutrients. Dosage adjustments should always be made under the guidance of the healthcare provider based on factors such as stool consistency, weight gain, and nutritional status.