The following inotropic drugs can be used in acute shock Except:

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the use of inotropic drugs in acute shock is crucial for providing appropriate care to pediatric patients. In this question, the correct answer is D) Milrinone. Milrinone is a phosphodiesterase inhibitor that acts as an inotropic and vasodilator agent. It is commonly used in pediatric patients with heart failure but is not typically used in acute shock situations due to its vasodilatory effects, which can potentially worsen hypotension. Option A) Digitalis is a cardiac glycoside that increases myocardial contractility. Although it has inotropic effects, it is not typically used in acute shock management in pediatric patients. Option B) Dopamine is a catecholamine that can increase blood pressure and heart contractility. It is commonly used in acute shock situations to improve cardiac output. Option C) Dobutamine is a synthetic catecholamine with predominantly beta-1 adrenergic effects, making it a useful inotropic agent for patients in acute shock as it increases heart contractility without significant vasodilation. Educationally, knowing the appropriate use of inotropic drugs in pediatric patients is essential for nurses working in pediatric settings. Understanding the differences between these medications and their effects on the cardiovascular system can help nurses make informed decisions in managing pediatric patients in critical conditions.

Correct Answer: A

Rationale: In the context of pediatric nursing, understanding the physiological responses to serious illness is crucial for providing effective care to young patients. In this question, the correct answer is option A) Blood pressure. During serious illness, the body often initiates a stress response leading to an increase in heart rate, respiratory rate, and activation of accessory respiratory muscles as compensatory mechanisms to maintain oxygenation and circulation. However, blood pressure may not always increase and can actually decrease in certain conditions as a result of shock or other factors. Option B) Heart rate is often increased as part of the body's response to stress and illness to ensure an adequate supply of oxygenated blood to vital organs. Option C) Respiratory rate can also increase to enhance oxygen intake and carbon dioxide elimination during illness. Option D) Action of accessory respiratory muscles may be seen in conditions where there is respiratory distress or increased work of breathing. Educationally, this question highlights the importance of recognizing and understanding the various physiological responses that can occur in pediatric patients with serious illnesses. It underscores the need for nurses to monitor vital signs closely and interpret them in the context of the individual patient's condition to provide timely and appropriate interventions. By knowing the expected responses to serious illness, nurses can better assess and manage pediatric patients, ultimately improving outcomes and quality of care.

Correct Answer: C

Rationale: In this question, the correct answer is C) Dilute artificial formula. Total body sodium depletion occurs when there is an inadequate amount of sodium in the body compared to the amount of water. Dilute artificial formula can lead to total body sodium depletion in infants due to the low sodium content in the formula. A) SIADH (syndrome of inappropriate antidiuretic hormone) is associated with water retention, not sodium depletion. B) Psychogenic polydipsia is excessive thirst leading to water intake but does not directly relate to sodium depletion. D) Nephrotic syndrome involves protein loss in the urine but not necessarily total body sodium depletion. Educationally, understanding the relationship between sodium intake and body balance is crucial in pediatric nursing. Nurses must be able to identify the causes and symptoms of sodium imbalances in children to provide appropriate care and interventions. Monitoring sodium levels in infants on formula is essential to prevent complications related to total body sodium depletion.

Correct Answer: B

Rationale: The correct answer is B) Medullary relapse. In acute leukemia, medullary relapse is the most common type of relapse. This is because leukemia primarily affects the bone marrow where blood cells are produced. Medullary relapse refers to the recurrence of leukemia in the bone marrow. Option A) Clinical relapse is incorrect because clinical relapse is a broader term that encompasses various types of relapse, including medullary, CNS, and testicular relapse. It does not specify the specific location of the relapse. Option C) CNS relapse is incorrect because while relapse can occur in the central nervous system (CNS), it is less common than medullary relapse in acute leukemia. Option D) Testicular relapse is incorrect because this type of relapse is specific to leukemia spreading to the testicles, which is less common than medullary relapse. In an educational context, understanding the types of relapse in leukemia is crucial for pediatric nurses caring for children with this condition. Recognizing the most common type of relapse, which is medullary relapse, helps nurses in monitoring and managing the disease effectively. It also highlights the importance of regular assessments and follow-up to detect relapse early and initiate appropriate interventions.

Correct Answer: B

Rationale: In pediatric nursing, understanding the various causes of purpura is crucial for accurate assessment and diagnosis. The correct answer, B) Anaphylactoid purpura, is the commonest cause of non-thrombocytopenic purpura in children. This condition, also known as Henoch-Schönlein purpura, is characterized by immune-mediated inflammation of small blood vessels, leading to purpuric rash, joint pain, abdominal pain, and kidney involvement. Option A) Disseminated intravascular hemolysis (DIC) is incorrect because it is a cause of thrombocytopenic purpura due to platelet consumption in the coagulation process. Option C) Acute lymphoblastic leukemia is incorrect as it is associated with thrombocytopenia rather than non-thrombocytopenic purpura. Option D) Hypersplenism is also incorrect because it results in splenic sequestration of platelets leading to thrombocytopenia. Educationally, this question highlights the importance of recognizing different types of purpura in children and understanding the underlying pathophysiology to provide appropriate care. Nurses should be able to differentiate between thrombocytopenic and non-thrombocytopenic purpura to guide treatment interventions and ensure optimal outcomes for pediatric patients.