A child is admitted to the hospital for hypercalcemia and is placed on diuretic therapy. Which diuretic would the nurse expect to administer?

Correct Answer: A

Rationale: Furosemide (Lasix) is a loop diuretic that acts on the ascending loop of Henle in the kidney to increase calcium excretion. In the setting of hypercalcemia, where there is an elevated level of calcium in the blood, Furosemide can help promote the elimination of excess calcium through the urine, thereby aiding in the management of hypercalcemia.

Correct Answer: B

Rationale: Angiotensin II is the most potent compound in the renin-angiotensin-aldosterone system for raising blood pressure. It acts as a powerful vasoconstrictor, leading to increased systemic vascular resistance. Angiotensin II is formed from angiotensin I through the action of the angiotensin-converting enzyme. While renin initiates the cascade by converting angiotensinogen to angiotensin I, it is angiotensin II that exerts the strongest pressor effect.

Correct Answer: C

Rationale: In the management of heart failure, the preferred diuretic due to its demonstrated significant mortality reduction in patients with heart failure is Spironolactone (Aldactone). Spironolactone is a potassium-sparing diuretic that not only helps in reducing fluid overload but also exerts additional benefits through its aldosterone antagonistic effects. By blocking aldosterone receptors, Spironolactone helps in reducing myocardial fibrosis and remodeling, leading to improved outcomes in heart failure patients. The other options listed are not preferred for significant mortality reduction in heart failure: A) Furosemide (Lasix): While Furosemide is commonly used to manage fluid overload in heart failure, it does not offer the same mortality benefits as Spironolactone. B) Hydrochlorothiazide (HydroDIURIL): Hydrochlorothiazide is a thiazide diuretic that is not typically used for the management of heart failure. It is more commonly used for hypertension and edema due to other causes. D) Mannitol (Osmitrol): Mannitol is an osmotic diuretic that is not commonly used in the management of heart failure. It is more often used for conditions such as cerebral edema or acute kidney injury. In pediatric nursing practice, understanding the rationale behind choosing specific medications for conditions like heart failure is crucial for providing safe and effective care to pediatric patients. It is essential to be aware of the pharmacological properties of diuretics and their impact on pediatric patients with heart failure to optimize treatment outcomes and minimize adverse effects.

Correct Answer: C

Rationale: In the treatment of Parkinson's disease, the goal of pharmacologic therapy is to balance cholinergic and dopaminergic activity in the brain, which is why option C is correct. Dopamine is a neurotransmitter that is deficient in Parkinson's disease, leading to motor symptoms. By aiming to balance cholinergic (acetylcholine) and dopaminergic activity, medications can help alleviate symptoms and improve motor function in patients with Parkinson's disease. Option A, to increase the amount of acetylcholine at the pre-synaptic neurons, is incorrect because Parkinson's disease is primarily characterized by a lack of dopamine, not acetylcholine. Option B, to reduce the amount of dopamine available in the substantia nigra, is also incorrect as the goal is to increase dopamine levels to compensate for the deficiency. Option D, to block dopamine receptors in pre-synaptic and post-synaptic neurons, is not aligned with the treatment approach for Parkinson's disease, which focuses on enhancing dopamine activity rather than blocking it. Educationally, understanding the goals of pharmacologic therapy in Parkinson's disease is crucial for pediatric nurses caring for patients with this condition. By grasping the rationale behind the medications used, nurses can ensure safe administration, monitor for effectiveness, and educate patients and families on the purpose and expected outcomes of treatment. This knowledge enhances the quality of care provided to pediatric patients with Parkinson's disease and contributes to better patient outcomes.

Correct Answer: C

Rationale: Following the administration of Gardasil, the HPV vaccine, routine screening with a PAP test is necessary. While Gardasil protects against certain types of HPV, it does not cover all strains that could lead to cervical cancer. Therefore, individuals who have received the vaccine should still undergo regular PAP tests to screen for cervical abnormalities caused by other HPV strains.