Alkali therapy for the treatment of metabolic acidosis in RDS may result in all the following EXCEPT

Correct Answer: D

Rationale: In the treatment of metabolic acidosis in Respiratory Distress Syndrome (RDS), alkali therapy is often utilized to correct the acid-base imbalance. The correct answer, option D, "hyperkalemia," is the exception among the listed outcomes. Alkali therapy, which typically involves the administration of sodium bicarbonate, can lead to an increased risk of hyperkalemia due to the movement of potassium out of cells in exchange for hydrogen ions, potentially elevating serum potassium levels. Option A, "skin slough from infiltration," is incorrect as alkali therapy can indeed cause skin slough from infiltration due to its alkaline nature, which can lead to tissue damage upon extravasation. Option B, "increased serum osmolarity," is incorrect. Alkali therapy can actually decrease serum osmolarity as it helps in correcting the acidosis, which can contribute to decreased serum osmolarity. Option C, "hypernatremia," is also incorrect. Alkali therapy does not typically result in hypernatremia; in fact, it can help in the correction of acidosis without affecting sodium levels significantly. Educationally, understanding the potential complications and effects of alkali therapy in the context of treating metabolic acidosis in RDS is crucial for pediatric clinical nurse specialists. This knowledge helps in providing safe and effective care to pediatric patients with RDS and metabolic imbalances, ensuring that treatment interventions are monitored closely to prevent adverse outcomes such as hyperkalemia.

Correct Answer: B

Rationale: In hemolytic disease of the newborn caused by Rh incompatibility, the correct answer that is FALSE is B) Never occurs in the first-born infant. This statement is incorrect because hemolytic disease of the newborn can occur in the first pregnancy if the mother is Rh-negative and the baby is Rh-positive. A) Infant being Rh-positive is true as the condition arises when an Rh-negative mother carries an Rh-positive fetus. C) Maternal antibody titers can indeed help predict the severity of fetal disease by monitoring the levels of antibodies in the mother's blood. D) Severe anemia is frequent in hemolytic disease of the newborn due to the destruction of the baby's red blood cells by maternal antibodies. Educationally, understanding hemolytic disease of the newborn is crucial for pediatric nurses to provide appropriate care to at-risk newborns. It is vital for nurses to recognize the risk factors, signs, and symptoms of this condition to intervene promptly and prevent complications. By knowing the false statement and understanding the true aspects of Rh incompatibility, nurses can contribute to better outcomes for newborns affected by this condition.

Correct Answer: A

Rationale: Intrauterine transplacental infection is a critical concern for both the fetus and newborn as it can have serious consequences on their health. In this scenario, the correct answer is option A) Hepatitis B virus (HBV). HBV is known to be transmitted from mother to baby through the placenta or during childbirth, resulting in a high risk of chronic infection, liver disease, and even liver cancer later in life for the infant. Option B) Rubella is also a transplacental infection that can cause congenital rubella syndrome, leading to serious birth defects. However, it is not specifically related to liver problems like HBV. Option C) Toxoplasmosis is another intrauterine infection, but it typically affects the central nervous system and can lead to severe neurological issues, not primarily liver-related problems. Option D) Parvovirus B19 can cause fetal complications like anemia, but it is not commonly associated with liver issues in the same way as HBV. Educationally, understanding the transmission and consequences of intrauterine infections is crucial for healthcare providers, especially pediatric clinical nurse specialists working with neonates and infants. Recognizing the specific risks posed by different pathogens helps in timely interventions, monitoring, and prevention strategies to safeguard the health of both mother and child.

Correct Answer: D

Rationale: Neonatal sepsis is a serious condition in newborns and can have high mortality rates. The correct answer is D) Pseudomonas. Pseudomonas aeruginosa is a known cause of neonatal sepsis and is associated with high mortality rates due to its virulence factors and resistance to many antibiotics commonly used in newborns. Option A) Staphylococcus - coagulase negative is less likely to cause severe sepsis in neonates compared to other species of staphylococcus. Option B) Group B streptococcus is a common cause of neonatal sepsis but typically has a lower fatality rate compared to Pseudomonas. Option C) Escherichia coli can cause severe neonatal sepsis but is not typically associated with the highest case fatality rate compared to Pseudomonas. Educationally, understanding the etiology of neonatal sepsis and the pathogens associated with higher mortality rates is crucial for pediatric clinical nurse specialists to provide prompt and effective care. Recognizing the differences in pathogen virulence and appropriate treatment strategies can significantly impact patient outcomes in neonatal sepsis cases.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) history of physical illness. The disorder described seems to be psychosomatic in nature, as the recurrent severe abdominal pain is not explained by physical exam or lab findings. Therefore, a history of physical illness would be least likely associated as it does not align with the psychosomatic nature of the symptoms. Option A) emotional distress and Option B) history of marital conflict are likely associated as stressors can exacerbate or trigger psychosomatic symptoms. Option C) child maltreatment, whether emotional, can also contribute to the development of psychosomatic symptoms in children. Educationally, understanding psychosomatic disorders in pediatric patients is crucial for clinical nurse specialists. Recognizing the impact of psychological factors on physical symptoms is essential for providing holistic care to pediatric patients experiencing unexplained symptoms. It highlights the importance of thorough assessment, including psychosocial factors, in managing pediatric patients with recurrent abdominal pain.