Regarding disorders of acid-base balance, what is the compensatory mechanism that takes place to keep the pH normal when there is bicarbonate loss in urine?

Correct Answer: C

Rationale: In disorders of acid-base balance, when there is bicarbonate loss in urine, the compensatory mechanism that occurs to maintain normal pH is hyperventilation. Hyperventilation helps to expel more carbon dioxide from the body, which leads to a decrease in carbonic acid levels, helping to counterbalance the loss of bicarbonate ions. This increased respiratory rate helps to shift the pH back towards normal by reducing the acidity in the blood. Option A, extracellular shift of potassium, is not the correct answer because it does not directly compensate for bicarbonate loss in urine. Hyperchloremia (Option B) refers to elevated levels of chloride ions in the blood and is not a compensatory mechanism for bicarbonate loss. Loss of organic acid in urine (Option D) is not a compensatory mechanism for bicarbonate loss either. Understanding the compensatory mechanisms in acid-base balance is crucial in pediatric nursing to assess, diagnose, and intervene effectively in cases of acid-base imbalances in children. It is essential for nurses to recognize these mechanisms to provide appropriate care and treatment to pediatric patients with such conditions.

Correct Answer: A

Rationale: In pediatric nursing, understanding the appropriate dose of adrenaline for cardiac arrest is critical to providing effective and safe care to pediatric patients. The correct answer is option A) 10 microgram/kg. The rationale behind this correct dose is based on the principles of pediatric pharmacology and resuscitation protocols. Adrenaline is a key medication used during cardiac arrest to improve cardiac output and perfusion. The recommended dose of adrenaline in pediatric cardiac arrest is 10 micrograms per kilogram of body weight. This dose is carefully calculated to provide the necessary hemodynamic support without causing harm or overdose in pediatric patients. Incorrect options: B) 100 microgram/kg - This dose is ten times higher than the recommended dose for pediatric cardiac arrest. Administering such a high dose can lead to adverse effects like tachycardia, hypertension, and potential harm to the child. C) 1000 microgram/kg - This dose is excessively high and could result in severe adverse effects such as cardiac arrhythmias, hypertension, and even cardiac arrest. It is far beyond the safe and effective dose range for pediatric patients. D) 10 milligram/kg - This option represents a dose in milligrams rather than micrograms. Administering adrenaline in milligrams instead of micrograms would result in a significantly higher dose than intended, posing a serious risk of harm to the pediatric patient. Educational Context: Understanding the correct dosing of medications in pediatric nursing is crucial for providing safe and effective care. Pediatric patients require individualized care based on their age, weight, and specific physiological characteristics. By knowing the correct dose of medications like adrenaline for pediatric cardiac arrest, nurses can help improve outcomes and prevent potential medication errors that could harm the patient. It is essential for pediatric nurses to be well-versed in pediatric pharmacology and resuscitation guidelines to ensure the best possible care for their young patients.

Correct Answer: C

Rationale: In this question, the correct answer is C) Early septic shock. Distributive shock is a type of shock where there is a widespread dilation of the blood vessels leading to decreased systemic vascular resistance. In early septic shock, there is a systemic inflammatory response to infection which can lead to vasodilation and distributive shock. Option A) Cardiac tamponade is incorrect as it is a type of obstructive shock where there is impaired filling of the heart due to fluid accumulation in the pericardial sac. Option B) Dehydration is incorrect as it leads to hypovolemic shock, not distributive shock. Option D) Critical aortic stenosis is incorrect as it leads to obstructive shock due to impaired blood flow out of the heart. Educationally, understanding the different types of shock and their underlying causes is crucial for pediatric nurses to provide appropriate and timely interventions. Recognizing the signs and symptoms of distributive shock, such as seen in early septic shock, allows nurses to initiate treatment promptly to stabilize the child's condition and prevent further complications. This knowledge helps in improving patient outcomes and providing quality care in pediatric settings.

Correct Answer: A

Rationale: In pediatric nursing, recognizing early signs of shock in infants is crucial for prompt intervention and prevention of deterioration. In this scenario, the correct answer is A) Hypotension. Hypotension is a late sign of shock in infants, not an early manifestation. Option B) Irritability is a common early sign of shock in infants, as they may become fussy, restless, or inconsolable. Option C) Peripheral vasoconstriction is a compensatory mechanism in response to shock, leading to cool extremities, not an early manifestation. Option D) Tachycardia is also an early sign of shock in infants, as the body tries to compensate for decreased cardiac output. Educationally, understanding the progression of shock symptoms in infants is vital for nurses to provide timely and appropriate care. By knowing the early signs, nurses can intervene quickly to prevent further deterioration and improve patient outcomes. Continuous education and practice in recognizing pediatric shock symptoms are essential for nurses working in various healthcare settings.

Correct Answer: D

Rationale: During cardiopulmonary resuscitation (CPR) of an infant, chest compressions should be performed with 2 fingers of one hand. This technique is recommended by the American Heart Association for infants under 1 year old because their chests are small and compressing with 2 fingers allows for proper depth and pressure without causing harm to the infant's delicate chest. Option A: Using the heel of one hand and the other hand on top is not recommended for infants during CPR as it can lead to excessive force being applied, potentially causing injury to the infant's chest. Option B: Using the heel of one hand only is not the correct technique for infant CPR as it may not provide adequate pressure and depth needed for effective chest compressions on a small infant. Option C: Using 4 fingers of one hand is also not the recommended method for infant CPR as it can lead to uneven pressure distribution and may not achieve the appropriate compression depth required to circulate blood effectively. Educational Context: Understanding the correct technique for performing chest compressions during infant CPR is crucial for healthcare providers and caregivers to ensure the best chances of successful resuscitation in an emergency situation involving an infant. Proper training and practice using the recommended 2-finger technique can help improve outcomes and save lives.