A 9-mo-old infant is recently diagnosed with bilateral retinoblastoma; examination under anesthesia reveals bilateral multifocal involvement of the retina. An important next step in the management is

Correct Answer: B

Rationale: In this scenario, the correct next step in managing a 9-month-old infant recently diagnosed with bilateral retinoblastoma with multifocal involvement of the retina is option B, which is to conduct a retinal examination of 1st degree relatives. This is crucial as retinoblastoma is a hereditary condition, and early detection in family members is essential for timely intervention. Option A, radiotherapy of both eyes, is not typically the first-line treatment for retinoblastoma due to potential complications and long-term effects on vision and eye development in infants. Option C, orbital ultrasonography, may not provide as much valuable information as a retinal examination of family members in terms of guiding the management of the infant's condition. Option D, bilateral enucleation, is a drastic measure that is usually reserved for cases where other treatment options have been exhausted or if the tumor is too advanced to preserve vision. In an educational context, understanding the importance of genetic predisposition and family screening in cases of retinoblastoma is crucial for pediatric emergency nurses. It highlights the need for a holistic approach to care, considering not only the immediate management of the infant but also the broader implications for family members and future generations. This case underscores the significance of thorough assessment and comprehensive care planning in pediatric oncology.

Correct Answer: D

Rationale: In the context of pediatric emergency nursing, understanding teratogens and their effects is crucial for providing safe and effective care to infants and children. The correct answer, option D - hypothermia, is not a recognizable teratogen. Teratogens are substances or factors that can cause birth defects or developmental abnormalities in the fetus when exposed during pregnancy. Ethanol (option A) is a well-known teratogen that can lead to fetal alcohol syndrome and a range of developmental issues. Antiepileptic medications (option B) have also been identified as teratogens, with certain drugs increasing the risk of congenital malformations. Toxoplasmosis (option C) is caused by a parasite that can be transmitted to the fetus during pregnancy, resulting in serious complications. Educationally, it is important to understand the impact of teratogens on fetal development to prevent potential harm to unborn children. By recognizing and avoiding exposure to teratogens, healthcare providers can help promote healthy pregnancies and reduce the risk of birth defects. In the context of pediatric emergency nursing, this knowledge is essential for assessing and managing potential risks to both mother and fetus in emergency situations.

Correct Answer: B

Rationale: In pediatric emergency nursing, understanding growth and development milestones is crucial for providing appropriate care to children. The correct answer to the question, "The birthweight usually quadruples by the age of 2 years," is option B. The birthweight of an infant typically doubles by 5-6 months of age and triples by 1 year. By the age of 2 years, a child's birthweight usually quadruples. This is a significant marker of healthy growth and development in early childhood. Option A (1.5 years) is incorrect because by 1.5 years, a child's birthweight would typically have tripled, not quadrupled. Option C (2.5 years) is incorrect as by this age, a child's birthweight would have likely exceeded quadrupling. Option D (3 years) is also incorrect as by 3 years, a child's birthweight would have far surpassed quadrupling, indicating continued growth and development. Understanding these growth milestones is essential for pediatric nurses as it helps in assessing a child's overall health, development, and nutritional status. Recognizing deviations from these expected milestones can alert healthcare providers to potential issues that may require further evaluation and intervention.

Correct Answer: D

Rationale: In pediatric emergency nursing, it is crucial to assess developmental milestones to identify potential delays or concerns early on. The correct answer, option D, is the most appropriate clue indicating a need for assistance by the age of 24 months. Children should typically be using short sentences by this age, such as "Daddy went bye-bye." This signifies the child's ability to string words together to form basic sentences, which is an important language development milestone. Option A, speech not understood by familiar listeners, is a common issue in early language development and may not necessarily indicate a need for help by 24 months. Option B, speech not understood by unfamiliar listeners, is also common as children's speech clarity continues to improve with age and practice. Option C, not asking questions using interrogative words, is also a developmental milestone that may vary among children. Educationally, understanding these developmental markers helps nurses and healthcare providers identify potential speech and language delays early, allowing for timely interventions and support. By recognizing these clues, healthcare professionals can provide appropriate resources and referrals to ensure optimal developmental outcomes for children.

Correct Answer: C

Rationale: In this scenario, option C is the most appropriate response. Confirming the presence of asbestos through laboratory evaluation is crucial to accurately assess the risk. If asbestos is found, involving a certified engineer for expert evaluation ensures that proper steps are taken to address the issue safely and effectively. Option A is incorrect as immediate removal of insulation without proper assessment can lead to the release of asbestos fibers, posing a greater risk to health. Option B neglects the need for expert evaluation and action. Option D is not recommended as it downplays the serious health risks associated with asbestos exposure. From an educational standpoint, this scenario highlights the importance of evidence-based decision-making in pediatric emergency situations. It emphasizes the need for thorough assessment, proper risk management, and involving qualified professionals to ensure the safety and well-being of children and the community. Understanding the correct protocols for handling potential asbestos exposure is crucial for healthcare providers working in pediatric settings.