Contraindications for gastric lavage include:

Correct Answer: D

Rationale: In pediatric nursing, understanding the indications and contraindications for gastric lavage is crucial for safe and effective patient care. In this scenario, the correct answer is D) All of the above - Glasgow Coma Scale 5, kerosene ingestion, and ingestion of corrosives are all contraindications for gastric lavage in pediatrics. Gastric lavage is contraindicated in patients with a Glasgow Coma Scale of 5 because they are at a high risk of aspiration due to their decreased level of consciousness. Kerosene ingestion can lead to lipid pneumonia if aspirated during lavage, making it a contraindication. Ingestion of corrosives can cause further damage to the esophagus and stomach if lavage is attempted. Educationally, it is important for pediatric nurses to understand these contraindications to avoid causing harm to the patient. Knowledge of when not to perform gastric lavage is just as critical as knowing when it is indicated. This information helps nurses make informed decisions based on the specific needs and condition of the pediatric patient in their care.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding the management of hyperkalemia is crucial for providing safe and effective care to pediatric patients. In this scenario, the correct answer is B) Beta blockers. Beta blockers are not a primary treatment for hyperkalemia. Instead, they are contraindicated in the management of hyperkalemia as they can further increase potassium levels by inhibiting beta-2 receptors, which play a role in potassium uptake by cells. Therefore, giving beta blockers to a patient with hyperkalemia can exacerbate the condition. A) Calcium gluconate IV is a correct treatment for hyperkalemia as it stabilizes the cardiac membrane potential in the setting of elevated potassium levels. C) Sodium bicarbonate can help shift potassium into cells temporarily, thereby reducing serum potassium levels. D) Sodium polystyrene sulfonate (Kayexalate) is a cation exchange resin that binds potassium in the gastrointestinal tract and facilitates its excretion. Educationally, understanding the appropriate treatments for hyperkalemia is essential for nurses working with pediatric patients, as untreated hyperkalemia can lead to life-threatening cardiac arrhythmias. Nurses need to be familiar with the actions of different medications used in hyperkalemia treatment to provide prompt and effective care to pediatric patients in critical situations.

Correct Answer: A

Rationale: The correct answer is option A) Chromosomal breakage test for this patient presenting with microcephaly, microphthalmia, absent thumb, ectopic kidney, and recurrent epistaxis. These clinical manifestations are indicative of a rare genetic disorder called Fanconi anemia, characterized by chromosomal instability leading to breakage and increased risk of malignancies. Option B) Hemoglobin electrophoresis is used to diagnose hemoglobinopathies like sickle cell disease, not relevant to this patient's presentation. Option C) Schilling test is used to assess vitamin B12 absorption, not related to the symptoms described. Option D) Osmotic fragility test is used to diagnose conditions like hereditary spherocytosis, which does not align with the patient's symptoms. In an educational context, understanding the rationale behind diagnostic testing based on presenting symptoms is crucial in pediatric nursing. Recognizing the pattern of anomalies and linking them to specific genetic disorders is essential for early diagnosis and appropriate management of pediatric patients with rare conditions like Fanconi anemia. This case highlights the importance of a comprehensive assessment and knowledge of diagnostic tests in pediatric nursing practice.

Correct Answer: C

Rationale: In pediatric Hodgkin's lymphoma, bone marrow infiltration is not a typical criterion. This is because pediatric Hodgkin's lymphoma primarily involves the lymphatic system and typically presents with enlarged, rubbery, and discrete lymph nodes. Option A is incorrect as Hodgkin's lymphoma typically arises in cervical lymph nodes in most cases. Option B is incorrect as affected lymph nodes are described as rubbery and discrete, not typically firm or matted together. Option D is incorrect as pruritis (itching) is indeed one of the B symptoms associated with Hodgkin's lymphoma. Educational Context: Understanding the criteria for pediatric Hodgkin's lymphoma is crucial for nurses caring for pediatric patients. Recognizing the key features of this condition can aid in early detection, prompt treatment, and improved outcomes. Nurses play a vital role in monitoring for signs and symptoms, educating families about the disease, and supporting children and their caregivers throughout the treatment process.

Correct Answer: A

Rationale: Normocytic normochromic anemia refers to a type of anemia where the red blood cells are normal in size and color. In this case, the correct answer is A) Aplastic anemia. Aplastic anemia is a disorder where the bone marrow fails to produce enough blood cells, leading to low levels of red blood cells, white blood cells, and platelets. This results in normocytic normochromic anemia due to the decreased production of red blood cells with normal size and hemoglobin content. Option B) a-Thalassemia is incorrect because it typically presents as microcytic hypochromic anemia, with small and pale red blood cells. Option C) Folic acid deficiency anemia is also incorrect as it results in macrocytic anemia, with large red blood cells. Option D) Iron deficiency anemia leads to microcytic hypochromic anemia, characterized by small and pale red blood cells. In an educational context, understanding the different types of anemia is crucial for nurses caring for pediatric patients. Recognizing the characteristics of normocytic normochromic anemia, such as in aplastic anemia, helps in providing appropriate care and interventions to manage the condition effectively. Nurses must be able to differentiate between the various types of anemia based on their etiology and characteristics to ensure accurate assessment and treatment for pediatric patients.