In pediatric shock, which of the following is an early sign?

Correct Answer: D

Rationale: In pediatric shock, recognizing early signs is crucial for prompt intervention. The correct answer is D) Tachycardia. Tachycardia is a common early sign of pediatric shock due to the body's attempt to compensate for decreased perfusion. The increased heart rate is a physiological response to maintain cardiac output. Option A) Hypotension is a late sign in pediatric shock. Children can maintain their blood pressure until a significant amount of blood volume is lost, making hypotension a more advanced indicator. Option B) Disturbed consciousness level typically occurs in the later stages of shock when the brain is not receiving adequate oxygen and nutrients. Option C) Cheyne-Stokes breathing is an abnormal pattern of breathing characterized by alternating periods of deep and shallow breathing. While it can occur in various conditions, it is not specific to pediatric shock. Educationally, understanding the progression of signs in pediatric shock is vital for nurses caring for pediatric patients. Early recognition of tachycardia can trigger timely interventions to prevent further deterioration. This knowledge equips nurses to provide effective and efficient care, potentially saving lives in critical situations.

Correct Answer: D

Rationale: In pediatric nursing, understanding raised intracranial pressure (ICP) is crucial for timely intervention and prevention of serious complications. The correct definition of raised ICP in children is when the pressure exceeds 20 mmHg for more than five minutes (Option D). This definition is based on the fact that children's developing brains are more vulnerable to pressure changes, requiring prompt recognition and management to prevent neurological damage. Option A (Increased ICP more than 8 mmHg for more than one day) is incorrect because an ICP of 8 mmHg is within normal limits, and the time frame mentioned is not clinically significant 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 considered normal, and one hour is not typically a critical timeframe for raised ICP assessment. Option C (Increased ICP more than 10 mmHg for more than one minute) is incorrect as an ICP of 10 mmHg is still within normal limits, and one minute is too short to diagnose raised ICP accurately. Understanding these distinctions is vital for nurses caring for pediatric patients at risk for increased ICP due to conditions such as head trauma, tumors, or infections. Early recognition of raised ICP signs and symptoms can lead to prompt interventions, potentially preventing further brain damage in children.

Correct Answer: B

Rationale: The correct answer is B) Expelling a foreign body in the airway in the unconscious child. The Heimlich maneuver, also known as abdominal thrusts, is a first-aid procedure used to dislodge an obstruction in the airway, particularly in cases where the person is choking and unable to breathe or speak. In pediatric nursing, this skill is crucial as children are prone to putting small objects in their mouths, which can lead to choking emergencies. Performing the Heimlich maneuver promptly can save a child's life by clearing the airway and restoring normal breathing. Option A) Assessing if the child is breathing or not is incorrect because the Heimlich maneuver is not used for assessment but for intervention in cases of airway obstruction. Option C) Chest compression in a large child to ensure adequate compression is incorrect as chest compressions are part of CPR (Cardiopulmonary Resuscitation) and are not performed during the Heimlich maneuver. Option D) Opening airway in the presence of a possible cervical spine injury is incorrect because the Heimlich maneuver is specifically for clearing airway obstructions and is not indicated for suspected cervical spine injuries where movement of the neck should be minimized. Educational Context: Pediatric nurses must be well-versed in emergency procedures like the Heimlich maneuver to respond effectively to choking incidents in children. Understanding the correct technique, indications, and contraindications of the Heimlich maneuver is crucial for pediatric healthcare providers to provide timely and life-saving interventions in emergency situations. Regular training, practice, and staying updated on pediatric emergency protocols are essential for pediatric nurses to deliver safe and competent care to pediatric patients.

Correct Answer: B

Rationale: In the treatment of hypernatremia, the maximum accepted rate of drop of serum sodium per 24 hours is crucial to prevent complications like cerebral edema. The correct answer is B) 12 mmol/L. This rate is considered safe and effective in correcting hypernatremia without causing rapid shifts in osmolarity, which can lead to neurological damage. Option A) 8 mmol/L is too conservative and may not effectively correct hypernatremia in a timely manner, potentially prolonging the patient's risk of complications. Option C) 16 mmol/L and Option D) 20 mmol/L represent overly aggressive decreases in serum sodium levels, which can precipitate cerebral edema and other neurological issues. In an educational context, understanding the appropriate rate of correction for electrolyte imbalances like hypernatremia is essential for pediatric nurses to provide safe and effective care to their patients. Nurses must carefully monitor serum sodium levels, collaborate with the healthcare team to adjust treatment plans as needed, and ensure that corrections are made within the recommended parameters to promote optimal patient outcomes.

Correct Answer: A

Rationale: In pediatric nursing, understanding the physiological responses to serious illness is crucial for providing optimal care to young patients. In this question, the correct answer is option A) Blood pressure. During serious illness, the body often responds with an increase in heart rate, respiratory rate, and the action of accessory respiratory muscles as compensatory mechanisms to maintain oxygenation and perfusion. However, blood pressure may not always increase in response to serious illness, as it can vary based on the specific condition and the body's compensatory mechanisms. Option B) Heart rate is often increased during serious illness as the body tries to maintain cardiac output and perfusion to vital organs. Option C) Respiratory rate can also increase as the body attempts to improve oxygenation and remove carbon dioxide. Option D) Action of accessory respiratory muscles may be seen in conditions where there is increased work of breathing, such as respiratory distress. Educationally, this question highlights the importance of recognizing and understanding the various physiological responses that can occur in pediatric patients with serious illnesses. By differentiating between these responses, nurses can assess the child's condition accurately, intervene promptly, and provide appropriate care to improve outcomes. It underscores the need for nurses to have a comprehensive understanding of pediatric pathophysiology and the body's responses to illness to deliver safe and effective care.