Early sign of shock is:

Correct Answer: D

Rationale: In pediatric nursing, recognizing early signs of shock is crucial for timely intervention and preventing complications. The correct answer is D) Tachycardia. In pediatric patients, tachycardia is often one of the earliest signs of shock. When the body is in a state of shock, the heart rate increases as a compensatory mechanism to maintain adequate tissue perfusion. Option A) Hypotension is a late sign of shock in pediatric patients. Children can maintain their blood pressure until they are significantly hypovolemic, so hypotension is a concerning sign but not an early indicator. Option B) Disturbed consciousness level may occur in shock, but it is a later and more severe manifestation. Children typically exhibit tachycardia before alterations in consciousness. Option C) Cheyne-Stokes breathing is a pattern of breathing characterized by alternating periods of deep, rapid breathing followed by apnea. While it can occur in some conditions, it is not a specific early sign of shock in pediatric patients. Educationally, it is important for nursing students to understand the progression of shock in pediatric patients. Recognizing early signs allows for prompt intervention, which can significantly impact patient outcomes. Emphasizing the significance of tachycardia as an early indicator of shock helps students prioritize assessments and interventions in pediatric emergencies.

Correct Answer: D

Rationale: In this case, the correct answer is D) Metabolic alkalosis without compensation. To understand why this is the correct interpretation of the ABG results, let's break it down: 1. pH: 7.48 - The pH is elevated, indicating alkalosis. 2. PaCO2: 42 - The PaCO2 is within normal range (35-45 mmHg), indicating that there is no primary respiratory acidosis or alkalosis. 3. HCO3: 30 - The HCO3 level is elevated, indicating metabolic alkalosis. Therefore, the ABG results show a high pH and high bicarbonate level without any significant compensation from the respiratory system, suggesting a primary metabolic alkalosis without any respiratory component. Now, let's analyze why the other options are incorrect: A) Metabolic acidosis without compensation: This is incorrect because the pH is elevated, not decreased, and the HCO3 level is high, indicating alkalosis, not acidosis. B) Respiratory alkalosis with partial compensation: This is incorrect because there is no significant decrease in PaCO2 to indicate respiratory alkalosis, and the HCO3 level is high, indicating metabolic alkalosis. C) Respiratory alkalosis with full compensation: This is incorrect because there is no significant decrease in PaCO2 to indicate respiratory alkalosis, and the HCO3 level is high, indicating metabolic alkalosis. Educational context: Understanding how to interpret ABG results is crucial in pediatric nursing as it helps in identifying and managing various acid-base imbalances in pediatric patients. It is essential for nurses to be able to differentiate between respiratory and metabolic imbalances and understand the compensatory mechanisms involved. This knowledge is vital for providing safe and effective care to pediatric patients with complex health needs.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Von Willebrand disease. Von Willebrand disease is a common inherited bleeding disorder characterized by a deficiency or dysfunction of von Willebrand factor, which plays a crucial role in platelet adhesion to damaged blood vessels. This deficiency leads to prolonged bleeding time despite having a normal platelet count. Now, let's analyze why the other options are incorrect: A) Hemophilia A is a genetic disorder that results in a deficiency of clotting factor VIII, leading to prolonged bleeding, but it does not affect platelet count. C) Leukemia is a type of cancer affecting the blood and bone marrow, which can lead to low platelet count (thrombocytopenia), but it does not typically cause prolonged bleeding time with a normal platelet count. D) Hypersplenism is a condition where the spleen removes blood cells prematurely from circulation, including platelets, leading to a decreased platelet count, but it does not typically cause prolonged bleeding time with a normal platelet count. Educational Context: Understanding the relationship between platelet count, bleeding time, and various disorders is crucial in pediatric nursing. By grasping the pathophysiology of conditions like Von Willebrand disease, nurses can provide appropriate care, anticipate complications, and educate patients and families effectively. This knowledge aids in accurate assessment, diagnosis, and management of pediatric patients with bleeding disorders, ultimately improving patient outcomes.

Correct Answer: D

Rationale: The correct answer is D) Beta-thalassemia, which is associated with microcytosis. Beta-thalassemia is an inherited blood disorder characterized by reduced production of hemoglobin, leading to small red blood cells (microcytosis) and anemia. Option A) Folic acid deficiency is associated with macrocytic anemia, not microcytosis. Folic acid is necessary for red blood cell production, and its deficiency leads to enlarged red blood cells. Option B) Immune hemolytic anemia is characterized by the premature destruction of red blood cells by the immune system, leading to hemolysis. This condition does not specifically cause microcytosis. Option C) Hypothyroidism can lead to normocytic anemia, where red blood cells are normal in size but insufficient in quantity. It is not directly associated with microcytosis. In a pediatric nursing context, understanding the different causes of anemia and their characteristic features is crucial for accurate diagnosis and appropriate treatment. Recognizing the link between beta-thalassemia and microcytosis helps nurses provide targeted care and education to patients and their families. It also highlights the importance of thorough assessment and interpretation of laboratory findings in pediatric patients presenting with anemia.

Correct Answer: D

Rationale: The correct answer is D) Parvovirus type B 19. Parvovirus B19 is known to cause transient aplastic crisis in patients with hereditary spherocytosis due to their increased susceptibility to infection-induced hemolysis. Parvovirus B19 infects red blood cell precursors in the bone marrow, leading to decreased red blood cell production and exacerbation of anemia in patients with hereditary spherocytosis. Option A) German measles virus (rubella) is not typically associated with transient aplastic crisis in hereditary spherocytosis. Option B) Human herpes virus 6 is not commonly linked to aplastic crisis in hereditary spherocytosis. Option C) Adenovirus is not a common cause of transient aplastic crisis in individuals with hereditary spherocytosis. Educationally, understanding the specific viral infections that can trigger complications in patients with hereditary spherocytosis is crucial for pediatric nurses to provide appropriate care and monitoring for these patients. This knowledge helps nurses anticipate and manage potential complications effectively, ensuring better outcomes for pediatric patients with hereditary spherocytosis.