Pyridoxine is not affected in patients receiving

Correct Answer: D

Rationale: Pyridoxine, also known as vitamin B6, is essential for various metabolic processes in the body, including the synthesis of neurotransmitters and the metabolism of amino acids. In patients receiving corticosteroids, pyridoxine levels are not affected because corticosteroids do not interfere with its absorption or utilization. A) Isoniazid is a medication used to treat tuberculosis and is known to cause pyridoxine deficiency by increasing its excretion, leading to neurological symptoms. B) Valproate, an antiepileptic medication, can lead to pyridoxine deficiency by inhibiting its conversion to its active form, pyridoxal-5-phosphate, resulting in neurological side effects. C) Phenytoin, another antiepileptic drug, can also cause pyridoxine deficiency by increasing its metabolism, leading to decreased levels of active vitamin B6 in the body. In a pediatric gastrointestinal nursing context, understanding the impact of medications on essential nutrients like pyridoxine is crucial for providing comprehensive care to children. Nurses need to be aware of potential drug-nutrient interactions to prevent deficiencies and associated complications. By knowing which medications affect pyridoxine levels and which do not, nurses can optimize patient outcomes and provide appropriate interventions to support nutritional health in pediatric patients.

Correct Answer: B

Rationale: Vitamin B12 is crucial for various physiological functions in the body, particularly in the development and maintenance of the nervous system. In this case, option B, "skeletal development," is the correct answer as vitamin B12 does not play a direct role in this process. Option A, "hematopoiesis," is incorrect as vitamin B12 is essential for the production of red blood cells and supports normal blood cell formation. Option C, "psychomotor development," is incorrect because vitamin B12 is important for the neurological development that underpins psychomotor skills. Option D, "central nervous system myelination," is incorrect as vitamin B12 is vital for the proper myelination of nerves in the central nervous system. In a pediatric gastrointestinal nursing context, understanding the role of vitamin B12 is essential for providing appropriate care to children with gastrointestinal issues that may impact nutrient absorption. By knowing that vitamin B12 is primarily involved in hematopoiesis and neurological functions, nurses can better assess, plan, and implement interventions to support pediatric patients' overall health and development.

Correct Answer: A

Rationale: In pediatric gastrointestinal nursing, assessing body ascorbate stores is crucial for monitoring the nutritional status of children. The best indicator of body ascorbate stores is leukocyte ascorbate concentration (Option A). Leukocytes actively accumulate ascorbate, providing a more reliable reflection of body stores compared to plasma or urine levels. Leukocyte ascorbate concentration is less affected by short-term dietary intake fluctuations, making it a more stable marker for assessing overall ascorbate status. Option B, plasma ascorbate level, can fluctuate widely based on recent dietary intake and may not accurately reflect tissue stores. Option C, urinary ascorbate level, primarily indicates recent intake and renal excretion, rather than body stores. Option D, amino acid level, is not a direct indicator of ascorbate stores and is unrelated to vitamin C status. Educationally, understanding the significance of different biomarkers for assessing nutritional status is vital for pediatric nurses. By knowing the strengths and limitations of each marker, nurses can make informed decisions about patient care, dietary interventions, and supplementation strategies to optimize children's health outcomes. In pediatric practice, accurate assessment of ascorbate status can guide interventions to prevent deficiencies and promote overall well-being in children.

Correct Answer: D

Rationale: In X-linked hypophosphatemic rickets, the correct features include coxa vara and windswept deformity (Option D). Coxa vara is a deformity of the hip joint that presents with a decreased angle between the head and neck of the femur, leading to gait abnormalities. Windswept deformity refers to a characteristic pattern of leg deformity seen in this condition. Option A, craniotabes, frontal bossing, and rickets, are features commonly associated with nutritional rickets, not specifically X-linked hypophosphatemic rickets. Craniotabes is a softening of the skull, frontal bossing refers to a prominent forehead, and rickets is a condition characterized by weakened or soft bones. Option B, scoliosis and lordosis, are not typical features of X-linked hypophosphatemic rickets. Scoliosis is a lateral curvature of the spine, while lordosis is an inward curvature of the lower back. Option C, rachitic rosary and Harrison groove, are classic findings in vitamin D deficiency rickets, not X-linked hypophosphatemic rickets. Rachitic rosary describes a beading of the ribs at the costochondral junctions, and Harrison groove is a horizontal groove at the level of the diaphragm due to the pulling of respiratory muscles in rickets. Understanding these distinctions is crucial for pediatric gastrointestinal nurses as they care for children with various metabolic bone disorders. Recognizing the specific clinical features of X-linked hypophosphatemic rickets aids in accurate diagnosis, appropriate interventions, and improved patient outcomes.

Correct Answer: A

Rationale: The correct answer is A) X-linked hypophosphatemic rickets because this hereditary form of rickets can manifest in apparently healthy carriers, such as the mother in this case. X-linked hypophosphatemic rickets is a genetic disorder that affects the body's ability to regulate phosphate levels, leading to symptoms like bowed legs, short stature, and bone deformities. The mother may show mild or no symptoms but can pass on the genetic mutation to her offspring. Option B) autosomal dominant hypophosphatemic rickets is incorrect because it does not typically present in carriers who are asymptomatic. This type of rickets requires the affected individual to show symptoms. Option C) autosomal recessive hypophosphatemic rickets is also incorrect as carriers usually do not exhibit symptoms, making it less likely to help diagnose an apparently healthy mother with the disease. Option D) Fanconi syndrome is not a form of rickets but rather a kidney disorder that affects the reabsorption of various substances in the kidney tubules. It is not directly related to the hereditary forms of rickets mentioned in the question. In an educational context, understanding the different forms of rickets and their hereditary patterns is crucial for pediatric gastrointestinal nurses when assessing patients with suspected genetic conditions. Recognizing the subtle signs in apparently healthy carriers can aid in early diagnosis and intervention, especially in families with a history of genetic disorders. This knowledge helps nurses provide comprehensive care and genetic counseling to families affected by hereditary diseases.