Parents of a school-age child with hemophilia ask the nurse, "Which sports are recommended for children with hemophilia?" Which sport should the nurse recommend?

Choice A rationale:

Asthma. Rationale: A chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration are classic symptoms of asthma. Asthma is a chronic inflammatory condition of the airways characterized by bronchoconstriction, leading to symptoms such as wheezing, coughing, and shortness of breath. These symptoms often worsen during the expiratory phase of respiration, leading to the characteristic expiratory wheezing.

Choice B rationale:

Pneumonia. Rationale: Pneumonia is characterized by inflammation of the lung tissue and is often associated with productive cough, fever, chest pain, and sometimes wheezing. However, diffuse wheezing during the expiratory phase without significant productive cough is not a typical presentation of pneumonia.

Choice C rationale:

Bronchiolitis. Rationale: Bronchiolitis, caused by viruses such as RSV, commonly affects infants and young children. It presents with symptoms such as cough, wheezing, and respiratory distress. However, bronchiolitis typically involves lower airway inflammation and is often associated with viral upper respiratory symptoms. The presented case, with a chronic, nonproductive cough and diffuse wheezing during the expiratory phase, is more indicative of asthma.

Choice D rationale:

Foreign body in the trachea. Rationale: A foreign body in the trachea can cause acute respiratory distress and coughing. While it can lead to wheezing, the chronic nature of the symptoms described in the scenario (chronic, nonproductive cough and diffuse wheezing during the expiratory phase) is not consistent with a foreign body in the trachea.

E.

Choice A rationale:

Administer antibiotics. Rationale: Antibiotics are not indicated for respiratory syncytial virus (RSV) bronchiolitis, which is caused by a viral infection. RSV is a common cause of bronchiolitis in infants, and antibiotics do not treat viral infections. Using antibiotics in this situation would not be appropriate and can contribute to antibiotic resistance.

Choice B rationale:

Administer cough syrup. Rationale: Cough syrups are generally not recommended for infants and young children due to the risk of overdosing and potential adverse effects. Additionally, RSV bronchiolitis primarily requires supportive care and management of respiratory symptoms, which may include oxygen therapy in severe cases.

Choice C rationale:

Encourage infant to drink 8 ounces of formula every 4 hours. Rationale: Maintaining hydration is essential in the management of RSV bronchiolitis. However, the specific volume and frequency of formula intake may vary based on the infant's age, weight, and overall condition. It is important to assess the infant's tolerance and adjust the feeding schedule accordingly. Encouraging frequent, smaller feeds might be more appropriate for some infants to prevent overfeeding and vomiting.

Choice D rationale:

Institute cluster care to encourage adequate rest. Rationale: Cluster care, a nursing intervention involving grouping activities to minimize disturbances and promote longer periods of rest, is beneficial for infants with RSV bronchiolitis. Adequate rest helps conserve the infant's energy, facilitating the recovery process. This intervention supports the infant's overall well-being and aids in coping with respiratory distress.

Choice E rationale:

Place on noninvasive oxygen monitoring. Rationale: Infants with severe RSV bronchiolitis may experience respiratory distress and hypoxia, necessitating oxygen therapy. Noninvasive oxygen monitoring methods, such as pulse oximetry, allow healthcare providers to assess oxygen saturation levels without invasive procedures. Oxygen therapy can improve oxygenation and alleviate respiratory distress, supporting the infant's respiratory function and overall recovery.