One of the following metabolic abnormalities may be associated with tumor lysis syndrome:

Correct Answer: B

Rationale: In the context of pediatric oncology, tumor lysis syndrome (TLS) is a critical concern when treating patients with rapidly proliferating tumors. TLS is characterized by metabolic abnormalities resulting from the massive release of intracellular contents into the bloodstream following cancer treatment, particularly in response to chemotherapy. Hyperkalemia (Option B) is a classic feature of TLS due to the release of potassium from lysed cells. Hypernatremia (Option A) and hyponatremia (Option D) are not typically associated with TLS. Hypernatremia is more commonly seen in conditions like dehydration or diabetes insipidus, while hyponatremia can be caused by conditions like fluid overload or syndrome of inappropriate antidiuretic hormone (SIADH). Hypokalemia (Option C) is also not a characteristic finding in TLS. It is more commonly seen in conditions like diuretic use, gastrointestinal losses, or renal tubular disorders. In an educational context, understanding the metabolic abnormalities associated with TLS is crucial for pediatric nurses caring for oncology patients. Recognizing the signs and symptoms of TLS, including hyperkalemia, allows nurses to intervene promptly to prevent life-threatening complications. This knowledge also underscores the importance of close monitoring and early intervention in pediatric oncology settings to provide safe and effective care to vulnerable patients.

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: C

Rationale: The correct answer is C) The difference between unmeasured plasma cations & anions. The anion gap is an important concept in pediatric nursing as it helps in diagnosing various metabolic disorders such as metabolic acidosis. The anion gap is calculated by subtracting the sum of measured cations (sodium) from the sum of measured anions (chloride and bicarbonate) in the plasma. Option A is incorrect because the anion gap is not about the difference between positively and negatively charged plasma molecules in general. Option B is incorrect because the anion gap specifically relates to unmeasured anions, not just unmeasured negatively charged molecules in general. Option D is incorrect because the anion gap does not involve bicarbonate specifically, it is about the difference between unmeasured plasma cations and anions. Understanding the anion gap is crucial for nurses working with pediatric patients as abnormal values can indicate underlying health conditions that require prompt assessment and intervention. It is a valuable tool in assessing acid-base balance and can guide treatment decisions in pediatric patients with metabolic disturbances.

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.