Important causes of wheezing in infancy include all of the following except:

Correct Answer: D

Rationale: In pediatric nursing, understanding the causes of wheezing in infants is crucial for providing effective care. In this question, the correct answer is D) Hypocalcemia. Wheezing in infancy can be caused by various conditions, with hypocalcemia being a less common cause compared to the other options. Hypocalcemia, a low level of calcium in the blood, can lead to muscle spasms and laryngospasm but is not a typical cause of wheezing in infancy. Bronchiolitis (Option A) is a common viral respiratory infection that often leads to wheezing in infants. Asthma (Option B) is a chronic respiratory condition characterized by wheezing and is common in older children but can also present in infants. Gastroesophageal reflux (Option C) can lead to wheezing when stomach contents flow back into the esophagus and irritate the airways. Educationally, understanding the differential diagnosis of wheezing in infants is essential for nurses working in pediatric settings. By recognizing the various causes, nurses can provide timely and appropriate interventions to manage respiratory issues in infants effectively. This knowledge helps in assessing, planning, and implementing care plans tailored to the specific underlying cause of wheezing, promoting better outcomes for pediatric patients.

Correct Answer: D

Rationale: In pediatric nursing, understanding raised intracranial pressure (ICP) is crucial as it can lead to serious complications. The correct answer is D) Increased ICP more than 20 mmHg for more than five minutes. This option is correct because an ICP of more than 20 mmHg for an extended period indicates significant intracranial pressure, which can compromise cerebral perfusion and lead to brain damage. Option A) Increased ICP more than 8 mmHg for more than one day is incorrect as an ICP of 8 mmHg is within normal limits and one day is not a clinically significant timeframe for defining raised ICP. Option B) Increased ICP more than 6 mmHg for more than one hour is incorrect as an ICP of 6 mmHg is also within normal limits and one hour is not a significant duration to indicate raised ICP. Option C) Increased ICP more than 10 mmHg for more than one minute is incorrect as a threshold of 10 mmHg is relatively low and one minute is too short a duration to assess raised ICP accurately. Educationally, understanding the correct definition of raised ICP in children is vital for pediatric nurses as early recognition and intervention are essential in preventing complications such as brain herniation. Monitoring ICP levels, recognizing signs of increased ICP, and implementing appropriate interventions are key aspects of pediatric nursing care in managing neurologically compromised children.

Correct Answer: A

Rationale: In pediatric nursing, foreign body aspiration is a critical emergency that requires prompt recognition and intervention. The correct answer, A) History of foreign body aspiration is essential for diagnosis, is not true because often young children may aspirate a foreign body without any witnessed event, hence absence of relevant history. This is why healthcare providers must maintain a high index of suspicion for this condition. Option B) Negative clinical manifestations do not exclude F.B. aspiration, is correct because symptoms can be subtle or absent, making it crucial to consider foreign body aspiration even in the absence of overt clinical signs. Option C) Normal chest X-ray does not exclude F.B. aspiration, is also correct because not all foreign bodies are radiopaque and may not be visualized on an X-ray, necessitating a high level of clinical suspicion and potentially other diagnostic modalities. Option D) When F.B. aspiration is suspected, bronchoscopy must be done, is also correct because bronchoscopy is the definitive diagnostic and therapeutic intervention for foreign body aspiration. In an educational context, it is important for healthcare providers to be aware of the nuances of foreign body aspiration in pediatric patients, as early recognition and management can prevent serious complications such as respiratory distress or even death. Understanding the key clinical presentations, diagnostic modalities, and interventions is crucial for providing safe and effective care to children at risk for foreign body aspiration.

Correct Answer: C

Rationale: In the scenario of drowning, the most urgent immediate line of management at the scene is performing mouth-to-mouth breathing (Option C). This is crucial because in drowning, the primary concern is the lack of oxygen reaching the brain and other vital organs, leading to hypoxia and ultimately cardiac arrest. Mouth-to-mouth breathing helps to provide oxygen to the victim's lungs and subsequently to the bloodstream, improving oxygenation and increasing the chances of survival. Chest compression (Option A) may be needed if the victim has entered cardiac arrest, but without providing oxygen through mouth-to-mouth breathing first, the compressions alone are not as effective. Draining water from the stomach (Option B) and taking off wet clothing (Option D) are not immediate priorities in the management of a drowning victim. Educationally, it is crucial for healthcare providers, first responders, and the general public to understand the correct immediate actions to take in a drowning scenario. Quick and appropriate interventions can significantly impact the outcome for the victim. Training in basic life support techniques, including mouth-to-mouth breathing, should be widely encouraged to equip individuals with the skills needed to respond effectively in emergencies like drowning.

Correct Answer: B

Rationale: In pediatric nursing, understanding oxygen saturation levels is crucial for assessing a child's respiratory status. An oxygen saturation of 90% means that 90% of the hemoglobin in the blood is carrying oxygen, making option B the correct answer. This level indicates that there is some impairment in oxygen delivery to tissues and may warrant further assessment and intervention. Option A is incorrect because oxygen saturation is not directly related to the partial pressure of oxygen (PaO2). PaO2 of 90 mmHg does not equate to an oxygen saturation of 90%. Option C is incorrect as oxygen saturation represents the percentage of hemoglobin saturated with oxygen, not the percentage of oxygen in the inspired air. Option D is incorrect because there is no specific limit on how much additional oxygen a child can receive based solely on their oxygen saturation level. Educationally, this question highlights the importance of interpreting oxygen saturation levels accurately in pediatric patients. It underscores the significance of recognizing what oxygen saturation values indicate about oxygen transport in the body and how deviations from the normal range can impact a child's health. Nurses must be adept at assessing and responding to oxygen saturation levels to provide optimal care for pediatric patients with respiratory issues.