In pediatric basic life support, how is airway opening achieved in a 5-year-old child with a car accident?

Correct Answer: D

Rationale: In pediatric basic life support, achieving an open airway is crucial for optimal oxygenation and ventilation, especially in emergency situations like a car accident. The correct answer, option D - Jaw thrust, is the most appropriate technique for a 5-year-old child in this scenario. The jaw thrust maneuver is preferred in pediatric patients with suspected cervical spine injuries, as it allows for maintaining cervical spine alignment while opening the airway by displacing the mandible forward. This reduces the risk of exacerbating any potential spinal cord injury that may have occurred during the car accident. Option A - Head tilt and chin lift with neck extended, and Option B - Head tilt and chin lift with neck neutral, are techniques used in adults or conscious pediatric patients without suspected spinal injuries. However, in this case, these maneuvers could potentially worsen the child's condition by compromising spinal alignment. Option C - Abdominal thrust, also known as the Heimlich maneuver, is used for choking emergencies and is not appropriate for airway management in an unconscious child with a potential spinal injury. It is essential for healthcare providers, especially pediatric nurses, to be well-versed in the correct airway management techniques for different age groups and clinical scenarios to provide safe and effective care to pediatric patients in emergencies. Regular training and practice of pediatric basic life support skills are crucial to ensure readiness and competence in managing such critical situations.

Correct Answer: A

Rationale: Acute epiglottitis is a serious condition that can quickly progress to airway compromise in pediatric patients. Option A, "Fulminating course of high fever and drooling of saliva," is the correct answer because it accurately describes a classic presentation of acute epiglottitis. The rapid onset of symptoms, including high fever and drooling, is characteristic of this condition and requires prompt recognition and intervention to prevent respiratory distress. Option B, "Absence of toxic manifestations," is incorrect because acute epiglottitis typically presents with toxic manifestations such as fever, sore throat, and respiratory distress due to the rapid progression of inflammation in the epiglottis. Option C, "The most common cause is para-influenza," is incorrect as the most common causative organism for acute epiglottitis is actually Haemophilus influenzae type B, although with the introduction of the Hib vaccine, the incidence has decreased significantly. Option D, "Good response to nebulized adrenaline," is incorrect as the primary treatment for acute epiglottitis is securing the airway to prevent respiratory compromise. Nebulized adrenaline may provide temporary relief of symptoms but definitive management involves maintaining a patent airway through intubation or tracheostomy. In an educational context, understanding the key clinical features and management of acute epiglottitis is crucial for pediatric nurses to recognize and respond to this potentially life-threatening condition promptly. Nurses must be vigilant in assessing pediatric patients with suspected epiglottitis to prevent airway obstruction and ensure timely intervention to prevent complications.

Correct Answer: B

Rationale: The correct answer is B) Steatorrhea, chronic chest symptoms, and failure to thrive. Cystic fibrosis is a genetic disorder that primarily affects the lungs and digestive system. Steatorrhea, or the inability to properly digest and absorb fats, is a hallmark symptom of cystic fibrosis due to pancreatic insufficiency. Chronic chest symptoms result from thick, sticky mucus buildup in the lungs, leading to recurrent infections and breathing difficulties. Failure to thrive is common in children with cystic fibrosis due to malabsorption issues and increased energy expenditure. Option A is incorrect because meconium aspiration syndrome is a separate condition that occurs in newborns when they inhale meconium-stained amniotic fluid during delivery, not specific to cystic fibrosis. Option C is incorrect as hypernatremia is not a typical finding in cystic fibrosis. Instead, patients with cystic fibrosis are more prone to developing hyponatremia due to excessive salt loss in sweat. Option D is incorrect as hypercholesterolemia is not a typical feature of cystic fibrosis. In fact, individuals with cystic fibrosis often have difficulty gaining weight and may even have trouble absorbing essential nutrients, including fats. Educationally, understanding the key clinical manifestations of cystic fibrosis is crucial for healthcare professionals working with pediatric patients. Recognizing these symptoms can aid in early diagnosis and timely intervention to improve outcomes for individuals with this condition. It is essential to differentiate cystic fibrosis from other diseases with similar symptoms to provide appropriate care and support to affected children and their families.

Correct Answer: A

Rationale: In Immune Thrombocytopenic Purpura (ITP), platelet transfusion is indicated when the platelet count is critically low to prevent bleeding complications. The correct answer is A) 10,000/mm3 because at this level, the risk of spontaneous bleeding is significantly increased. Platelet transfusion helps raise platelet levels quickly to prevent or manage bleeding episodes in ITP patients. Option B) 30,000/mm3 is too high for platelet transfusion in ITP. Waiting until platelet levels drop to this point may put the patient at risk for bleeding complications. Option C) 40,000/mm3 and Option D) 50,000/mm3 are even higher thresholds for transfusion in the context of ITP and may not align with current evidence-based practice guidelines. Educationally, understanding the appropriate indications for platelet transfusion in ITP is crucial for pediatric nurses caring for these patients. It ensures timely and appropriate interventions to prevent complications. Nurses need to be aware of the specific platelet count thresholds that warrant intervention to provide safe and effective care to pediatric patients with ITP.

Correct Answer: C

Rationale: The correct answer is C) Hyperventilation. In the case of bicarbonate loss in urine, the body tries to compensate by increasing the rate and depth of breathing, which is known as hyperventilation. This helps to blow off more carbon dioxide, which in turn reduces carbonic acid levels in the blood, indirectly increasing the pH to compensate for the loss of bicarbonate. Option A) Extracellular shift of potassium is incorrect because it is not a compensatory mechanism for bicarbonate loss in urine. Potassium shifts may occur in other conditions but not specifically in response to bicarbonate loss. Option B) Reduction in urine output is not a compensatory mechanism for bicarbonate loss but rather a response to conserve water in cases of dehydration or reduced kidney function. Option D) Loss of organic acids in urine is also not a compensatory mechanism for bicarbonate loss. Organic acids in urine are typically related to metabolic processes rather than compensatory mechanisms for acid-base balance. In an educational context, understanding compensatory mechanisms in acid-base balance is crucial for pediatric nurses to assess and manage pediatric patients with various acid-base disorders. Recognizing the body's responses to maintain homeostasis is essential in providing effective and timely patient care.