All the following are possible cardiac complications at the acute stage of Kawasaki disease (KD) EXCEPT

Correct Answer: D

Rationale: In the acute stage of Kawasaki disease (KD), the correct answer, D) mitral regurgitation, is not a common cardiac complication. Myocarditis, pericarditis, and coronary artery aneurysm are all possible complications seen in KD due to the systemic inflammatory response affecting the heart and blood vessels. Myocarditis involves inflammation of the heart muscle, pericarditis is inflammation of the pericardium (the sac around the heart), and coronary artery aneurysm is a serious complication where the coronary arteries become weakened and form aneurysms. These complications can lead to serious cardiac issues and even result in long-term heart problems if not managed promptly. Educationally, understanding the cardiac complications of KD is crucial for pediatric nurses as early recognition and intervention can help prevent serious outcomes. Knowing the specific complications associated with KD aids in timely assessment, monitoring, and treatment, ultimately improving patient outcomes. Nurses need to be able to differentiate between potential complications to provide effective care and support for children with KD.

Correct Answer: D

Rationale: In pediatric nursing, the identification and differentiation of various causes of failure to thrive are crucial for providing appropriate care. Metabolic disorders are one of the key areas to consider in such cases. Option D, "renal symptoms," is the correct answer as it is not typically suggestive of metabolic problems. Renal symptoms would point more towards issues related to the kidneys rather than metabolic disorders. Option A, "insidious history," is indicative of a metabolic problem as these disorders often present with a gradual onset and progression, which aligns with an insidious history. Option B, "recurrent vomiting," is suggestive of metabolic issues as it can be a sign of metabolic acidosis or other metabolic disturbances. Option C, "neurologic symptoms," are also often seen in metabolic disorders due to the impact of metabolic derangements on the nervous system. Educationally, understanding these distinctions is vital for nurses caring for pediatric patients with failure to thrive. Recognizing the specific signs and symptoms associated with metabolic disorders can lead to timely interventions and improved outcomes for these vulnerable patients.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Hemorrhagic disease of the newborn. Hemorrhagic disease of the newborn is a condition characterized by bleeding in the first few days of life due to vitamin K deficiency, which can lead to serious complications if not treated promptly. This condition is common in infants who did not receive vitamin K prophylaxis at birth. Option A) Pyridoxine deficiency is incorrect because it is related to vitamin B6 deficiency, which does not typically present with bleeding in newborns. Option B) Severe scurvy is incorrect as scurvy is caused by vitamin C deficiency and is rare in newborns. Option D) Child abuse is incorrect in this context as the symptoms described are indicative of a medical condition (hemorrhagic disease of the newborn) rather than physical trauma. Educationally, understanding the importance of vitamin K administration to newborns is crucial for healthcare providers working in pediatric settings. This question highlights the significance of early recognition and management of hemorrhagic disease of the newborn to prevent serious complications such as intracranial hemorrhage. Healthcare professionals need to be vigilant in ensuring that newborns receive appropriate vitamin K supplementation to prevent this potentially life-threatening condition.

Correct Answer: B

Rationale: The correct answer is B) Prematurity. Prematurity, defined as a birth that occurs before 37 weeks of gestation, is the leading cause of low-birthweight births in America. Infants born prematurely are at a higher risk of health complications due to their underdeveloped organ systems. These babies may experience issues with breathing, feeding, and maintaining their body temperature. Option A) Intrauterine growth retardation (IUGR) is a condition where a baby doesn't grow well in the womb, leading to low birth weight, but it is not the predominant cause of low-birthweight births in America. Option C) Multiple gestations, or twins/triplets, can result in low-birthweight babies due to the shared resources in the womb. However, prematurity is still the primary cause of low birth weight in America. Option D) Uterine bleeding, while a concern during pregnancy, is not directly linked to low-birthweight births as prematurity is. In an educational context, understanding the causes of low birth weight is crucial for pediatric nurses to provide appropriate care for these vulnerable infants. By recognizing prematurity as the primary cause, nurses can focus on interventions to support these babies and their families effectively. Educating expectant mothers on the importance of prenatal care and healthy lifestyle choices to prevent premature births is also a key role for pediatric nurses.

Correct Answer: D

Rationale: The correct answer is D) Hemoglobin electrophoresis. In this scenario, the infant presents with significant jaundice, pallor, and a palpable liver, which are indicative of hemolytic disease such as ABO or Rh incompatibility. Hemoglobin electrophoresis is not necessary at this point as the clinical presentation does not suggest a hemoglobinopathy. Option A) Total and direct bilirubin levels are essential to assess the severity of jaundice and determine if there is conjugated hyperbilirubinemia, which could indicate liver disease or biliary obstruction. Option B) CBC with RBC morphology is important to assess for anemia, hemolysis, or other hematologic abnormalities that could contribute to the jaundice. Option C) Reticulocyte count helps to differentiate between hemolysis and liver pathology as a cause of jaundice. Elevated reticulocyte count would support a diagnosis of hemolysis. In an educational context, understanding the appropriate diagnostic steps in evaluating neonatal jaundice is crucial for pediatric nursing practice. This question highlights the importance of considering differentials and selecting appropriate investigations based on the clinical presentation to provide optimal care for neonates.