In renal tubular acidosis, acidosis is associated with which of the following?

Correct Answer: A

Rationale: In renal tubular acidosis (RTA), acidosis is associated with hyperchloremia because one of the key features of RTA is the inability of the kidneys to effectively excrete hydrogen ions (H+), leading to metabolic acidosis. Hyperchloremia occurs as a compensatory mechanism in response to the acidosis, where the body retains chloride ions to maintain electrical neutrality. Hyperkalemia is not directly related to acidosis in RTA. While potassium levels can be affected due to renal dysfunction, it is not the primary electrolyte imbalance associated with RTA. Hypernatremia is also not typically seen in RTA, as it refers to high sodium levels rather than chloride or potassium imbalances. An increase in unmeasured cations is not a characteristic feature of RTA and does not directly contribute to the acidosis seen in this condition. Educationally, understanding the electrolyte imbalances associated with different renal disorders like RTA is crucial for pediatric nurses. Recognizing these patterns helps in early identification, appropriate intervention, and overall improved care for pediatric patients with renal conditions. This knowledge ensures safe and effective nursing practice in managing pediatric patients with complex renal issues.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Mechanical obstruction to ventricular outflow. Obstructive shock is a type of shock where there is a physical obstruction to blood flow either within the heart or in the great vessels leading out of the heart. This obstruction prevents the heart from effectively pumping blood to the rest of the body, leading to decreased cardiac output and subsequent shock. Option B) Airway obstruction is incorrect because it relates to respiratory issues, not circulatory obstructions that are characteristic of obstructive shock. Option C) Generalized vasoconstriction is more typical of distributive shock, where blood vessels dilate and blood pools in the periphery, leading to decreased venous return to the heart. Option D) Hypovolemia is associated with hypovolemic shock, caused by a significant loss of intravascular volume. In an educational context, understanding the different types of shock is crucial for healthcare professionals, especially in pediatric nursing where quick and accurate assessment is vital. By knowing the specific characteristics of each type of shock, nurses can implement appropriate interventions promptly to stabilize the pediatric patient's condition and prevent further deterioration. This knowledge enhances patient outcomes and ensures competent care delivery in critical situations.

Correct Answer: C

Rationale: In pediatric nursing, understanding metabolic acidosis is crucial for providing safe and effective care to children. In this scenario, the correct answer is C) Renal tubular acidosis. Renal tubular acidosis is a condition where the kidneys are unable to effectively excrete acids into the urine, leading to an accumulation of acid in the body and resulting in metabolic acidosis with a high anion gap. This is different from other causes of metabolic acidosis such as diabetic ketoacidosis (option A), where there is an increase in ketone production leading to acidosis; salicylate poisoning (option B), which can lead to increased acid production and impaired excretion; and renal failure (option D), where the kidneys are unable to excrete acids effectively. Educationally, understanding the different causes of metabolic acidosis is important for nurses caring for pediatric patients, as it helps in identifying the underlying condition and providing appropriate interventions. By knowing that renal tubular acidosis can cause metabolic acidosis with a high anion gap, nurses can monitor for specific signs and symptoms, implement treatment strategies, and collaborate with the healthcare team to optimize patient outcomes.

Correct Answer: C

Rationale: In pediatric basic life support, the correct statement is that an Ambu bag can be used with or without oxygen. This is the correct answer because when providing rescue breaths to a child, the priority is to ensure adequate ventilation. Using an Ambu bag allows for controlled delivery of breaths, and oxygen can be added if available. This is crucial in maintaining oxygenation and perfusion during CPR. Option A is incorrect because the priority in pediatric basic life support is establishing effective ventilation and circulation through proper rescue breaths and chest compressions, not intubation. Intubation is a more advanced airway management technique. Option B is incorrect because chest compressions are indicated in pediatric CPR if the child is unresponsive and not breathing normally, regardless of the strength of heart sounds. Chest compressions help circulate oxygenated blood throughout the body. Option D is incorrect because the encircling technique is not used to perform chest compressions in pediatric CPR. Instead, two-finger chest compressions or heel of one hand technique is recommended for children to avoid causing injury. In an educational context, understanding the correct techniques and priorities in pediatric basic life support is crucial for healthcare providers working with children. Proper training and knowledge in pediatric CPR can make a significant difference in improving outcomes during pediatric emergencies. It is essential to prioritize effective ventilation and circulation to increase the chances of survival for pediatric patients in cardiac arrest.

Correct Answer: C

Rationale: The Look-Listen-Feel procedure is a fundamental assessment technique used in pediatric nursing to quickly evaluate a child's breathing. When a child presents with a medical emergency, assessing their breathing is crucial as respiratory distress is a common issue in pediatric patients. By observing for chest rise and fall (Look), listening for breath sounds (Listen), and feeling for airflow or chest movement (Feel), nurses can quickly determine if the child is breathing adequately. Option A, assessing for responsiveness, is important but is typically done before starting the Look-Listen-Feel procedure. Ensuring the child is responsive is the first step in any pediatric assessment to determine their level of consciousness. Option B, assessing for airway patency, is also vital in pediatric emergencies, but it is usually done before the Look-Listen-Feel procedure. Ensuring the airway is clear and unobstructed is a priority to allow effective breathing. Option D, assessing for circulation, involves checking the child's pulse and perfusion status, which is a separate component of the pediatric assessment. While circulation is essential, it is not the purpose of the Look-Listen-Feel procedure. In pediatric nursing, mastering the Look-Listen-Feel technique is crucial for quick and accurate assessment of a child's breathing status. This skill is especially important in emergency situations where prompt intervention can be life-saving. By understanding the rationale behind each step of the assessment process, nurses can provide efficient and effective care to pediatric patients.