One of the following can cause hyperkalemia without potassium excess:

Correct Answer: B

Rationale: In pediatric nursing, understanding the causes and implications of hyperkalemia is crucial for providing safe and effective care to children. In this scenario, the correct answer is B) Metabolic acidosis can cause hyperkalemia without potassium excess. Metabolic acidosis leads to the movement of potassium out of cells into the extracellular fluid, resulting in hyperkalemia. This occurs due to the exchange of hydrogen ions for potassium ions in an attempt to buffer the excess acid in the body. Option A) Addison's disease is associated with hyperkalemia due to adrenal insufficiency, leading to decreased aldosterone secretion, which impairs potassium excretion. Option C) Renal failure can cause hyperkalemia by impairing the kidneys' ability to excrete potassium effectively. Option D) Potassium-sparing diuretics can also lead to hyperkalemia by reducing potassium excretion in the kidneys. Educationally, understanding these mechanisms helps nurses differentiate between various causes of hyperkalemia in pediatric patients. Recognizing metabolic acidosis as a cause of hyperkalemia without potassium excess can guide appropriate treatment interventions and prevent potential complications in pediatric nursing practice.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Diarrhea. Diarrhea can lead to metabolic acidosis with a normal anion gap due to the loss of bicarbonate in the stool, leading to an increase in chloride. This results in an acidosis with a normal anion gap because the lost bicarbonate is replaced by chloride. A) Diabetic ketoacidosis causes an increased anion gap metabolic acidosis due to the accumulation of ketones in the blood. C) Salicylate poisoning leads to an increased anion gap metabolic acidosis by directly affecting acid-base balance. D) Renal failure causes a normal anion gap metabolic acidosis due to the inability of the kidneys to excrete acid effectively. In an educational context, understanding the causes of metabolic acidosis is crucial for pediatric nurses to provide effective care to pediatric patients. Knowing the specific differences between the various causes helps nurses in assessing and managing acid-base disorders in children. This knowledge is vital for providing safe and efficient care to pediatric patients with metabolic acidosis.

Correct Answer: D

Rationale: In pediatric nursing, resuscitation drugs are crucial in managing critically ill children. The correct answer, "D) Digitalis," is not typically used in pediatric resuscitation scenarios due to its potential toxic effects in children. Digitalis is a cardiac glycoside primarily used in adult populations with specific cardiac conditions like heart failure and atrial fibrillation. Atropine (A), Bicarbonate (B), and Epinephrine (C) are commonly used in pediatric resuscitation for different purposes. Atropine is used to treat bradycardia, bicarbonate can be given in cases of severe metabolic acidosis, and epinephrine is a key drug in managing cardiac arrest situations in children. Understanding the appropriate use of resuscitation drugs in pediatric patients is crucial for nurses caring for children in emergency situations. It is essential to be aware of the indications, dosages, and potential adverse effects of these medications to provide safe and effective care to pediatric patients in critical conditions. Being able to differentiate between drugs that are appropriate and inappropriate for pediatric resuscitation is fundamental knowledge for pediatric nurses to ensure optimal patient outcomes.

Correct Answer: D

Rationale: In pediatric nursing, understanding the indications and contraindications for gastric lavage is crucial for providing safe and effective care to children in emergency situations. Gastric lavage, the process of flushing out the stomach, is used in cases of certain poison ingestions. The correct answer, option D (All of the above), is the appropriate choice as all the listed conditions are contraindications for gastric lavage. Option A, Glasgow Coma Scale 5, indicates severe neurological impairment, making the child unable to protect their airway during the procedure, which can lead to aspiration and further complications. Option B, kerosene ingestion, is a petroleum-based product that can cause lung injury if aspirated during the lavage procedure. Option C, ingestion of corrosives, can cause damage to the esophagus, and lavage can further exacerbate the injury by increasing contact with the corrosive substance. Educationally, it is important for pediatric nurses to recognize when gastric lavage is contraindicated to prevent harm to the child. Understanding these contraindications helps nurses make informed decisions and provide appropriate care in poisoning emergencies. By knowing the specific scenarios in which gastric lavage should not be performed, nurses can advocate for alternative treatments and ensure the safety and well-being of their pediatric patients.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) 10. The Glasgow Coma Scale (GCS) is used to assess the level of consciousness in patients with head injuries. It is composed of three components: eye opening response, verbal response, and motor response. Each component is scored, and the total score indicates the level of consciousness. For a 4-year-old patient who opens eyes to a painful stimulus, is confused, and withdraws from pain, the GCS score would be as follows: - Eye opening response: 2 - Verbal response: 5 (confused) - Motor response: 3 (withdraws from pain) Total GCS score = 2 + 5 + 3 = 10 Option A) 8 is incorrect because it would indicate a lower level of consciousness which is not consistent with the patient's presentation. Option C) 11 is incorrect as well because the patient's responses do not align with a GCS score of 11. Option D) 13 is also incorrect as it would indicate a higher level of consciousness than what is described in the scenario. In a pediatric nursing context, understanding and correctly interpreting the Glasgow Coma Scale is crucial for assessing and managing head-injured patients. It helps healthcare providers to communicate effectively about the patient's level of consciousness and to monitor changes over time. This knowledge is essential for providing appropriate and timely interventions to optimize patient outcomes.