A parent of a child with acute renal failure (ARF) asks why peritoneal dialysis was chosen instead of hemodialysis. Which is the best response?

Correct Answer: C

Rationale: The correct answer is C) Peritoneal dialysis removes fluid at a slower, more controlled rate, which minimizes complications. In pediatric patients with acute renal failure, peritoneal dialysis is often preferred over hemodialysis due to several reasons. Peritoneal dialysis allows for a slower, more gradual removal of fluid and waste products from the body, which is better tolerated by children, especially those who are hemodynamically unstable. This gentle removal of toxins helps prevent rapid shifts in electrolytes and fluid balance, reducing the risk of complications such as hypotension and cardiac instability. Option A is incorrect because hemodialysis is indeed used in pediatric patients when necessary, but peritoneal dialysis is often preferred due to its advantages in this population. Option B is incorrect as peritoneal dialysis, like any medical procedure, can have complications such as infection, catheter-related issues, and metabolic imbalances. Option D is incorrect as hemodialysis is generally considered more efficient in terms of waste product clearance compared to peritoneal dialysis; however, the choice between the two modalities depends on the individual patient's condition and needs. In an educational context, it is important for healthcare providers to understand the rationale behind choosing peritoneal dialysis over hemodialysis in pediatric patients with acute renal failure to provide optimal care and prevent complications. Understanding the differences in dialysis modalities and their implications for pediatric patients' outcomes is crucial for nursing practice in pediatric nephrology.

Correct Answer: A

Rationale: In the early stages of acute hepatitis, manifestations typically include nonspecific symptoms such as nausea, vomiting, and generalized malaise, which are reflective of the body's systemic response to the inflammation of the liver. Option A, "Nausea, vomiting, and generalized malaise," is the correct answer because it aligns with these expected early symptoms of acute hepatitis. Option B, "Nausea, vomiting, and left-upper quadrant pain," is incorrect because left-upper quadrant pain is not a typical early manifestation of acute hepatitis. The pain associated with hepatitis is usually more generalized or located in the right upper quadrant due to liver inflammation. Option C, "Malaise and jaundice only," is incorrect because jaundice typically appears later in the course of hepatitis as the liver becomes more compromised. Malaise alone is also not specific enough to indicate acute hepatitis without the presence of other symptoms. Option D, "Jaundice only," is incorrect because jaundice usually develops later in the progression of acute hepatitis as liver function becomes more impaired. It is not typically an early symptom. Educationally, understanding the progression of symptoms in acute hepatitis is crucial for early recognition and intervention to prevent complications. By knowing the expected manifestations, healthcare providers can promptly diagnose and manage the condition, improving patient outcomes.

Correct Answer: B

Rationale: The correct answer is B) supracondylar region of the femur. Osteopenia, a condition of low bone density, commonly occurs post-SCI due to decreased weight-bearing activity and hormonal changes. The femur is a weight-bearing bone and is particularly vulnerable to fractures in individuals with osteopenia. Pathologic fractures in this population often occur at the supracondylar region due to the high mechanical stress placed on this area. Option A) distal tibia and Option D) proximal humerus are less common sites for fractures in individuals with osteopenia post-SCI. Fractures in the lumbosacral spine (Option C) are also possible but less common compared to fractures in weight-bearing bones like the femur. In an educational context, understanding the common sites of fractures in individuals with osteopenia post-SCI is crucial for nurses caring for pediatric patients. This knowledge helps in early identification of potential fractures, implementing preventive measures, and providing appropriate care to minimize complications associated with bone health in this population.

Correct Answer: B

Rationale: In the context of child sexual abuse, it is crucial to understand the dynamics of perpetrator profiles to effectively prevent and address such incidents. The correct answer, B) mothers, is less often involved in child sexual abuse compared to fathers, teachers, and family friends. This is supported by research showing that while mothers can be perpetrators, statistically they are less likely to engage in sexual abuse of children. Fathers are often identified as perpetrators due to their close proximity and authority within the family unit. Teachers, in positions of power and trust, may exploit their authority to abuse children under their care. Family friends, who have access to children and may be trusted by the family, also pose a significant risk. Educationally, understanding these different perpetrator profiles is essential for healthcare professionals, educators, and caregivers to recognize warning signs, intervene early, and provide support to victims. By knowing the common perpetrators, appropriate preventive measures can be implemented to safeguard children and create a safe environment for their well-being.

Correct Answer: C

Rationale: In the context of pediatric nursing and adoption, the least likely required investigation for a 1-year-old girl would be screening tests for sexually transmitted diseases (Option C). This is because sexually transmitted diseases are not typically relevant or applicable to a child of this age, as they are primarily transmitted through sexual contact, which would not be a concern for an infant. Neonatal screening tests (Option A) are crucial for identifying any congenital or genetic disorders early on to provide timely interventions. Immunization history (Option B) is essential to ensure the child has received necessary vaccinations to prevent infectious diseases. Cognitive tests (Option D) may be performed to assess the child's developmental milestones and cognitive abilities, which are important for monitoring overall growth and development. From an educational standpoint, understanding the rationale behind each investigation helps pediatric nurses prioritize and provide comprehensive care for children in various situations, including adoption. It is important to tailor medical investigations based on the child's age, health history, and specific needs to promote their well-being and ensure a smooth transition into their new family.