• patient outcomes.

- Question: Dexter is prone to allergies. When planning his care, what desired outcome
should the nurse prioritize?
a. Dexter states that his symptoms do not interfere with being able to play with his
friends.
b. Dexter is able to describe the cause of his allergic response.
c. Dexter states that he no longer has allergies.
d. Dexter states he enjoys taking medicine to prevent his allergy symptoms.
- Ans. A. The nurse would deem treatment successful if the child is able to maintain age-
appropriate activities despite having allergies. “Curing” allergies is not always a
possibility.

• SAFETY - focuses on preventing harm to patients.

- Question: Dexter is at his primary care provider’s office and the nurse had been asked to
assist with his physical examination. What safety intervention should the nurse use with
Dexter because he’s known to have many allergies?
a. Assess his blood pressure using a new blood pressure cuff.
b. Distract him by showing him a tropical fish tank.
c. Spot-check his oxygen saturation using pulse oximetry.
d. Use nonlatex gloves to conduct the examination.
- Ans. D. The nurse is aware that repeated exposures to latex can create allergies in
sensitive children. Distraction does not help protect his safety, and the use of a new blood
pressure cuff does not prevent allergic reactions.

• INFORMATICS - relates to the utilization of technology to promote safety and quality.

- Question: When Dexter’s mother heard he had another allergic diagnosis, she wanted
Dexter worked up for an immune system disorder “because he has colds all of the time.”
When reviewing the blood work of a child with allergic rhinitis, what results are most
helpful? Select all that apply.
a. Specific IgE levels to cat, dog, tree, grass, and weed mix
b. Serum immunoglobulins (IgG, IgA, and IgM)
c. Complete blood count with differential
d. Basic metabolic panel
- Ans, A, C. A complete blood count with differential is always the best starting point to
evaluate a child like Dexter. Allergic children generally have a higher number or
proportion of eosinophils in the blood. Children with immunodeficiencies may have
elevated neutrophil counts if they have an active bacterial infection. At baseline, a
reduced lymphocyte count or percentage may be a “red flag” for an immunodeficiency.
Allergic children generally have elevated IgE levels, both the overall serum IgE as well
as allergen-specific IgE.