On assessment of a child admitted with a diagnosis of Kawasaki Disease, the nurse expects to note which clinical manifestation of the acute phase of the disease?

Correct Answer: C

Rationale: In the acute phase of Kawasaki Disease, conjunctival hyperemia is a key clinical manifestation. This is because Kawasaki Disease is characterized by systemic vasculitis affecting medium-sized arteries, including the coronary arteries. Conjunctival hyperemia, along with other symptoms like rash, fever, and mucous membrane changes, are indicative of the inflammatory process affecting the blood vessels in the eyes. Option A, cracked lips, is a common finding in conditions like dehydration or vitamin deficiencies but is not specific to Kawasaki Disease. Option B, normal appearance, is unlikely in a child with Kawasaki Disease due to the systemic inflammation present. Option D, desquamation of the skin, typically occurs later in the subacute phase of the disease and is not a hallmark of the acute phase. Educationally, understanding the clinical manifestations of Kawasaki Disease is crucial for nurses caring for pediatric patients. Recognizing these signs early can lead to prompt treatment, which is essential in preventing complications such as coronary artery aneurysms. Nurses play a vital role in early identification and management of Kawasaki Disease, highlighting the importance of knowledge in assessing and caring for children with this condition.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Supraventricular tachycardia (SVT). SVT is a common dysrhythmia in pediatric patients and is characterized by a rapid heart rate originating above the ventricles. The toddler's heart rate of 230 beats per minute, along with other symptoms such as difficulty waking up, low blood pressure, and prolonged capillary refill time, are indicative of SVT. Option A) Rapid atrial flutter is incorrect because atrial flutter typically presents with a regular but very fast atrial rate, not as rapid as seen in this case. Option C) Sinus bradycardia is also incorrect as it refers to a slow heart rate originating from the sinus node, which is not consistent with the toddler's presentation of a heart rate of 230 beats per minute. Option D) Rapid atrial fibrillation is incorrect because atrial fibrillation presents with an irregularly irregular heart rate pattern, unlike the regular rapid rate seen in this case. Educationally, understanding pediatric dysrhythmias is crucial for nurses caring for children, especially in acute care settings. Recognizing the signs and symptoms of SVT and other dysrhythmias promptly can lead to timely interventions and improved patient outcomes. Nurses need to be skilled in assessing vital signs, recognizing abnormal findings, and implementing appropriate interventions to manage dysrhythmias effectively in pediatric patients.

Correct Answer: B

Rationale: In the context of pharmacology and pediatric cardiovascular conditions, it is crucial to understand the cardiac manifestations associated with genetic conditions such as Trisomy 21 (Down syndrome). The correct answer is B) Congenital heart defect. Children with Trisomy 21 have a significantly higher risk of congenital heart defects compared to the general population. This association is well-documented, with up to 50% of children with Down syndrome having some form of congenital heart anomaly. These defects can range from atrial septal defects (ASD), ventricular septal defects (VSD), atrioventricular septal defects (AVSD), to more complex anomalies. Therefore, it is imperative to evaluate children with Trisomy 21 for these cardiac abnormalities early on to provide appropriate management and interventions. Now, let's analyze why the other options are incorrect: A) Systemic hypertension: While individuals with Down syndrome may develop hypertension later in life, it is not a primary cardiac manifestation associated with Trisomy 21 in pediatric patients. C) Hyperlipidemia: Although individuals with Down syndrome are at increased risk of developing hyperlipidemia, this is not a cardiac manifestation but rather a metabolic concern. D) Cardiomyopathy: Cardiomyopathy is not a commonly associated cardiac manifestation in children with Trisomy 21. Congenital heart defects are more prevalent in this population. In an educational context, understanding these cardiac manifestations in pediatric patients with genetic conditions like Trisomy 21 is essential for nurses and healthcare providers involved in their care. Early identification and appropriate management of congenital heart defects can significantly impact the long-term health outcomes and quality of life for these individuals.

Correct Answer: B

Rationale: In pediatrics, screening for lead poisoning is crucial to prevent long-term health consequences. The correct answer is B) 12 months. At this age, children are more likely to come into contact with environmental sources of lead through hand-to-mouth behaviors. Screening at 12 months allows for early detection and intervention, which is vital in preventing lead poisoning-related developmental delays and cognitive impairments. Option A) 6 months is too early for routine lead screening as the risk of exposure may not be as significant at this age. Option C) 18 months and D) 24 months are too late to initiate screening, as lead exposure and poisoning can occur earlier and have detrimental effects on a child's health and development. Educationally, understanding the rationale behind the timing of lead screening in pediatrics is essential for nurses and healthcare providers working with children. It highlights the importance of early detection and intervention in mitigating the effects of lead poisoning, emphasizing the role healthcare professionals play in safeguarding children's health. By knowing when to start screening and why, nurses can advocate for preventive measures and provide appropriate care to promote optimal child health outcomes.

Correct Answer: D

Rationale: In the case of an infant hospitalized for nonorganic failure to thrive, the most appropriate nursing action is maintaining a consistent, structured environment (option D). This is crucial because infants thrive on predictability, routine, and consistency, which can help reduce stress and anxiety levels. A consistent environment can provide a sense of security and stability for the infant, promoting trust and attachment with caregivers. Option A, encouraging the infant to hold a bottle, is not the most appropriate action as it focuses on a physical aspect rather than addressing the underlying emotional and developmental needs of the infant. Option B, keeping the infant on bed rest, is not suitable for promoting growth and development in an infant as it restricts movement and interaction. Option C, rotating caregivers for more stimulation, may disrupt the establishment of trust and consistency, which are essential for infants in building secure attachments. From an educational standpoint, understanding the importance of a consistent and structured environment for infants with nonorganic failure to thrive is crucial for nursing care. It highlights the significance of meeting not only the physical needs but also the emotional and developmental needs of infants in promoting optimal growth and well-being. By prioritizing a stable environment, nurses can support the infant's overall health and development effectively.