During cardiopulmonary resuscitation of an infant, how should chest compressions be performed?

Correct Answer: D

Rationale: In pediatric nursing, performing chest compressions during cardiopulmonary resuscitation (CPR) is a critical skill that must be done correctly to ensure the best outcome for the infant. The correct answer, option D, "With 2 fingers of one hand," is based on the anatomical differences between infants and adults. Infants have smaller and more delicate chests compared to adults, requiring a different technique for chest compressions. Using two fingers (index and middle finger) of one hand allows for proper pressure application on the infant's chest without causing harm. This method ensures that the compressions are effective in circulating blood and oxygenating vital organs during CPR. Options A, B, and C are incorrect because using the heel of one hand, four fingers, or one hand alone may apply excessive force on the infant's delicate chest, potentially causing injury or not providing adequate compression depth. Understanding the correct technique for pediatric CPR is crucial for healthcare providers working with infants to prevent complications and improve survival rates during resuscitation efforts. Educationally, it is essential to teach healthcare professionals the specific techniques for performing CPR on infants to ensure they are equipped with the necessary skills to provide safe and effective care in emergency situations. By emphasizing the importance of using two fingers for chest compressions in infants, educators can help reinforce proper practices that align with best pediatric nursing standards and guidelines.

Correct Answer: C

Rationale: In pediatric nursing, it is crucial to understand the medications used during resuscitation to provide effective care for critically ill children. The correct answer is C) Digitalis. Digitalis is not used during resuscitation in pediatric patients. Here's why: 1. **Correct Answer (C - Digitalis):** Digitalis is a medication primarily used to treat heart conditions like heart failure and atrial fibrillation. It is not indicated for use during resuscitation as it does not have direct effects on the cardiovascular system in the acute setting. Therefore, it is not a part of the standard resuscitation protocols for pediatric patients. 2. **Incorrect Answers:** - A) Atropine: Atropine is commonly used during resuscitation to treat bradycardia by increasing heart rate. It is an essential medication in pediatric advanced life support protocols. - B) Bicarbonate: Bicarbonate may be used in specific cases of severe metabolic acidosis during resuscitation to help correct the acid-base balance. - D) Epinephrine: Epinephrine is a critical medication used during resuscitation to improve cardiac output, increase blood pressure, and support heart function in pediatric patients with cardiac arrest. It is a cornerstone of pediatric resuscitation guidelines. 3. **Educational Context:** Understanding the appropriate medications used during pediatric resuscitation is vital for healthcare providers working with children in critical situations. Knowing which drugs to administer, their mechanisms of action, and indications for use can significantly impact patient outcomes and survival rates during resuscitation efforts. In summary, digitalis is not used during pediatric resuscitation due to its limited acute effects on the cardiovascular system. Healthcare providers must be familiar with the correct medications and their roles in pediatric resuscitation to deliver timely and effective care to critically ill children.

Correct Answer: D

Rationale: The correct interpretation of the ABG results (pH: 7.48, PaCO2: 42, HCO3: 30) is D) Metabolic alkalosis without compensation. Explanation: 1. Metabolic alkalosis: The pH is elevated (alkalotic) above the normal range of 7.35-7.45, indicating alkalosis. The HCO3 level of 30 is also elevated, indicating a primary metabolic alkalosis. 2. Without compensation: In metabolic alkalosis, the respiratory system should respond by decreasing ventilation to retain CO2. However, the PaCO2 level of 42 is within normal range, indicating that there is no compensatory respiratory response. Why other options are incorrect: A) Metabolic acidosis without compensation: pH is alkalotic, not acidic. B) Respiratory alkalosis with partial compensation: HCO3 is elevated, indicating a metabolic, not respiratory, imbalance. C) Respiratory alkalosis with full compensation: HCO3 level being elevated contradicts respiratory alkalosis, and the PaCO2 is within the normal range. Educational context: Understanding ABG interpretation is crucial in pediatric nursing as it helps in assessing a child's acid-base balance, respiratory, and metabolic status. This knowledge is essential for providing appropriate interventions and monitoring the effectiveness of treatments. Recognizing the specific acid-base disturbances and their compensatory mechanisms is vital for delivering quality care to pediatric patients.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Von Willebrand disease. Von Willebrand disease is a genetic bleeding disorder characterized by a deficiency or dysfunction of von Willebrand factor, a protein that helps with platelet adhesion and blood clot formation. Despite having a normal platelet count, patients with Von Willebrand disease experience prolonged bleeding times due to the impaired platelet function caused by the deficiency of von Willebrand factor. Option A) Hemophilia A is incorrect because it is a disorder caused by a deficiency of clotting factor VIII, leading to prolonged clotting time, not bleeding time. Option C) Leukemia is incorrect as it is a type of cancer affecting white blood cells and does not directly impact platelet count or bleeding time. Option D) Hypersplenism is incorrect because while it can lead to a decrease in platelet count due to sequestration of platelets in the spleen, it does not cause prolonged bleeding time. Educationally, understanding the relationship between platelet count, bleeding time, and specific bleeding disorders is crucial for pediatric nurses. Recognizing the unique features of each condition and how they manifest in patients is essential for accurate diagnosis, treatment, and patient care. This knowledge ensures appropriate interventions are implemented promptly to prevent complications and improve outcomes for pediatric patients with bleeding disorders.

Correct Answer: D

Rationale: The correct answer is D) Beta-thalassemia. Beta-thalassemia is associated with microcytosis, which is characterized by smaller than normal red blood cells. This condition occurs due to a genetic defect in the production of beta-globin chains in hemoglobin, leading to ineffective erythropoiesis and subsequent microcytic anemia. A) Folic acid deficiency does not typically cause microcytic anemia. Folic acid deficiency is associated with macrocytic anemia, characterized by larger than normal red blood cells. B) Immune hemolytic anemia is not typically associated with microcytosis. This type of anemia results from the destruction of red blood cells by the immune system, leading to hemolysis but not necessarily microcytosis. C) Hypothyroidism is not directly linked to microcytic anemia. While hypothyroidism can lead to various hematologic abnormalities, microcytosis is not a typical feature of anemia associated with hypothyroidism. Understanding the etiology of different types of anemia is crucial for pediatric nurses to accurately assess and manage pediatric patients presenting with signs and symptoms of anemia. Recognizing the characteristic features of beta-thalassemia, such as microcytosis, can aid in early identification and appropriate intervention for affected children. This knowledge helps provide comprehensive care and support for pediatric patients with hematologic disorders.