All the following are long-term complications of intravenous cyclophosphamide EXCEPT

Correct Answer: B

Rationale: The correct answer is B) bladder cancer. Intravenous cyclophosphamide is a chemotherapeutic agent that is associated with various long-term complications due to its toxicity. Bladder cancer is not a common long-term complication associated with cyclophosphamide use. A) Bone marrow suppression is a well-known side effect of cyclophosphamide. It can lead to decreased production of blood cells, making patients more susceptible to infections, anemia, and bleeding. C) Leukemia is another potential long-term complication of cyclophosphamide use. Prolonged exposure to this drug can increase the risk of developing secondary cancers, including leukemia. D) Infertility is a significant concern with cyclophosphamide use, especially in women. This drug can cause damage to the ovaries, leading to infertility or premature menopause. Educational context: Understanding the potential long-term complications of medications used in pediatric patients is crucial for pediatric nurses. It allows them to monitor for signs and symptoms, provide appropriate education to patients and families, and collaborate with the healthcare team to minimize risks and manage complications effectively.

Correct Answer: C

Rationale: The correct answer is C) Epstein-Barr virus. Postinfectious arthritis is a condition where joint inflammation occurs after an infectious illness, often caused by viruses. Rubella, also known as German measles, is associated with arthritis, making it a likely causative viral infection. Varicella-zoster (causes chickenpox and shingles), cytomegalovirus (can cause arthritis in immunocompromised individuals), and herpes simplex virus (can lead to arthritis in some cases) are all known to be associated with arthritis as well, but the question asked for the LEAST likely causative viral infection. Educationally, understanding the associations between viral infections and arthritis is crucial for pediatric nurses. This knowledge helps in identifying potential causes of joint inflammation in children, allowing for timely interventions and appropriate management. By differentiating between the various viral infections and their likelihood of causing postinfectious arthritis, nurses can provide more effective care to pediatric patients with these conditions.

Correct Answer: D

Rationale: Juvenile dermatomyositis (JDM) is a rare autoimmune disease that primarily affects the skin and muscles in children. The correct answer to this question is D) facial erythema sparing the nasolabial folds is not a common cutaneous manifestation of JDM. Facial erythema sparing the nasolabial folds is typically seen in systemic lupus erythematosus (SLE) rather than JDM. This is an important differentiating factor between the two conditions. A) heliotrope rash of the eyelids, B) photosensitivity to ultraviolet light, and C) Gottron papules are all common cutaneous manifestations of JDM. The heliotrope rash is a classic finding in JDM, appearing as a purplish discoloration of the eyelids. Photosensitivity and Gottron papules (raised, scaly patches over the knuckles and finger joints) are also frequently observed in JDM cases. Understanding the specific cutaneous manifestations of pediatric diseases like JDM is crucial for nurses caring for pediatric patients. Recognizing these signs early can lead to prompt diagnosis and appropriate management, ultimately improving patient outcomes. It is essential for pediatric nurses to be knowledgeable about common pediatric conditions and their clinical presentations to provide optimal care to their young patients.

Correct Answer: A

Rationale: In patients with familial Mediterranean fever (FMF), secondary amyloidosis can develop due to chronic inflammation. The organ most seriously affected by secondary amyloidosis in FMF is the kidney. This is because amyloid deposits in the kidney can lead to renal failure, which is a serious complication of the disease. Option A, kidney, is the correct answer because renal involvement is a hallmark feature of secondary amyloidosis in FMF. The deposition of amyloid in the kidney can impair its function and ultimately lead to renal failure if left untreated. Options B, lung, C, nerve, and D, heart, are incorrect because while secondary amyloidosis can affect multiple organs, the kidney is most commonly and severely affected in FMF. Lung involvement is rare in FMF-related amyloidosis, nerve involvement typically manifests as peripheral neuropathy rather than systemic amyloidosis, and heart involvement is less common compared to renal involvement in FMF-related secondary amyloidosis. In an educational context, understanding the specific organ involvement in secondary amyloidosis associated with FMF is crucial for nurses caring for pediatric patients with this condition. Recognizing the signs and symptoms of renal impairment can help in early detection and intervention to prevent complications such as renal failure. This knowledge is essential for providing comprehensive care and improving outcomes for pediatric patients with FMF.

Correct Answer: D

Rationale: The correct answer is D) Takayasu arteritis, as it predominantly affects large blood vessels. Takayasu arteritis is a rare autoimmune disease that causes inflammation in the walls of the aorta and its main branches. This results in narrowing or blockage of these arteries, leading to reduced blood flow to various organs. Option A) Henoch-Schonlein purpura primarily involves small blood vessels and is characterized by a rash, joint pain, gastrointestinal symptoms, and kidney inflammation. Option B) Polyarteritis nodosa affects medium-sized arteries, leading to organ damage due to poor blood supply. It typically does not involve large blood vessels as in the case of Takayasu arteritis. Option C) Kawasaki disease mainly affects medium-sized arteries, particularly the coronary arteries in children. It is characterized by fever, rash, swollen lymph nodes, red eyes, lips, and tongue, and can lead to coronary artery aneurysms if not treated promptly. Educationally, understanding the differences in the types of vasculitis based on the size of blood vessels affected is crucial for pediatric nurses. Recognizing the specific characteristics and target organs of each disease aids in accurate diagnosis, appropriate treatment, and prevention of complications. Nurses play a key role in early identification, monitoring, and management of vasculitis in children to promote optimal outcomes and quality of life.