In patients with failure to thrive; chromosomal abnormality, intrauterine infection, and metabolic disorders need to be ruled out. All the following factors are suggestive of metabolic problems EXCEPT

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: 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.

Correct Answer: D

Rationale: In this scenario, the most appropriate therapy for the infant presenting with edema, rash, and alopecia post-extensive intestinal resection for necrotizing enterocolitis is option D: Administer zinc. Zinc deficiency is common in pediatric patients with malabsorption issues like short bowel syndrome post-intestinal resection. Zinc plays a crucial role in immune function, wound healing, and skin integrity. The symptoms described (edema, rash, alopecia) are consistent with zinc deficiency. Administering zinc supplementation can help alleviate these symptoms and support the infant's overall health and development. Option A (Administer salt-poor albumin) is incorrect because the symptoms presented are not indicative of a need for albumin administration. Option B (Increase the protein content in the hyperalimentation solution) is incorrect because the symptoms are not due to protein deficiency but rather a specific micronutrient deficiency. Option C (Administer recombinant alkaline phosphatase) is incorrect as it does not address the symptoms associated with zinc deficiency in this case. In an educational context, understanding the specific nutritional requirements of pediatric patients post-intestinal resection is crucial for providing optimal care. This case highlights the importance of recognizing the clinical manifestations of nutrient deficiencies and tailoring treatment strategies accordingly to promote the best outcomes for pediatric patients.

Correct Answer: A

Rationale: In pediatric nursing, understanding stereotypic movements is crucial for assessing and providing care for children. Stereotypic movements are repetitive, seemingly purposeless behaviors that may indicate underlying neurological or developmental conditions. In this question, the correct answer is A) Hand shaking. Hand shaking is not typically recognized as a stereotypic movement in the context of pediatric nursing. Eye blinking, head banging, and self-biting are commonly known stereotypic movements observed in children with various developmental disorders like autism spectrum disorder, Tourette syndrome, or intellectual disabilities. Educationally, it is important for nursing students to differentiate between stereotypic movements to accurately assess and intervene for their pediatric patients. Understanding the nuances of these movements can help identify underlying conditions, tailor care plans, and advocate for appropriate interventions. It also enables nurses to educate families about these behaviors and provide support and resources for managing them effectively. Being able to discern between different types of stereotypic movements enhances the quality of care provided to children with complex needs.