Hypoglycemia can occur suddenly in children, and parents and caregivers must be prepared to act quickly. What is the best action when a child is experiencing hypoglycemic symptoms?

The correct answers are a) Use a straw to administer the medication, b) Give the medication with vitamin C, and c) It is best to give the medication with food.

Choice A reason:

Using a straw to administer ferrous sulfate is recommended to prevent staining of the teeth. Ferrous sulfate, especially in liquid form, can cause discoloration of the teeth if it comes into direct contact with them. By using a straw, the medication bypasses the teeth, reducing the risk of staining.

Choice B reason:

Giving ferrous sulfate with vitamin C is beneficial because vitamin C enhances the absorption of iron. Vitamin C (ascorbic acid) helps convert iron into a form that is more easily absorbed by the body. Therefore, administering ferrous sulfate with a source of vitamin C, such as orange juice, can improve its effectiveness.

Choice C reason:

It is best to give ferrous sulfate with food to reduce gastrointestinal side effects. While iron is best absorbed on an empty stomach, it can cause stomach upset, nausea, and constipation. Taking the medication with food can help mitigate these side effects, making it more tolerable for the child.

Choice D reason:

Giving ferrous sulfate with milk is not recommended. Dairy products, including milk, can interfere with the absorption of iron. Calcium in milk binds with iron, reducing its bioavailability and effectiveness. Therefore, it is best to avoid giving ferrous sulfate with milk or other dairy products.

Choice A reason:

Decreased abdominal distention is not typically a sign of appendicitis perforation. In fact, perforation often leads to increased abdominal distention due to the release of intestinal contents into the abdominal cavity, causing inflammation and swelling. Therefore, this choice is incorrect.

Choice B reason:

Anorexia, or loss of appetite, is a common symptom of appendicitis but not specifically indicative of perforation2. While anorexia can be present in cases of perforation, it is not a definitive sign. The sudden relief of pain is a more critical indicator of perforation, as it suggests the appendix has ruptured, temporarily relieving pressure.

Choice C reason:

Bradycardia, or a slow heart rate, is not a typical sign of appendicitis perforation. In fact, appendicitis and its complications, such as perforation, are more likely to cause tachycardia (an increased heart rate) due to pain and infection. Therefore, this choice is incorrect.

Choice D reason:

Sudden relief from pain is a classic sign of appendicitis perforation. When the appendix ruptures, the pressure inside the appendix is relieved, leading to a temporary decrease in pain. However, this is followed by a rapid onset of severe pain as the contents of the appendix spread throughout the abdominal cavity, causing peritonitis. This sudden change in pain is a critical indicator that the appendix has perforated and requires immediate medical attention.