The mother of a hospitalized 2-year-old child with viral laryngotracheobronchitis (croup) asks the nurse why the health care provider did not prescribe antibiotics. Which response should the nurse provide?

Correct Answer: C

Rationale: The correct answer is C) "Antibiotics are not indicated unless there is a bacterial infection." In the case of viral laryngotracheobronchitis (croup), the causative agent is typically a virus, not bacteria. Antibiotics are only effective against bacterial infections, not viral ones. Prescribing antibiotics in the absence of a bacterial infection can lead to antibiotic resistance and unnecessary side effects without providing any benefit to the child. Option A) "Your child may be allergic to antibiotics" is incorrect because the decision to not prescribe antibiotics is not based on potential allergies but rather on the nature of the illness. Option B) "Your child is too young to receive antibiotics" is incorrect as age alone is not the determining factor for prescribing antibiotics in this case. Option D) "Your child still has maternal antibodies from birth and does not need antibiotics" is incorrect because while maternal antibodies may provide some protection, they are not a substitute for appropriate medical treatment if a bacterial infection is not present. From an educational standpoint, it is crucial for nurses to understand the principles of antibiotic stewardship and the appropriate use of antibiotics to prevent the development of antibiotic resistance. Educating parents about the rationale behind treatment decisions can help foster understanding and trust in the healthcare provider's expertise.

Correct Answer: B

Rationale: The correct answer is B) a chronic, productive cough. In the case of cystic fibrosis (CF), early respiratory symptoms often involve the buildup of thick mucus in the airways, leading to a chronic, productive cough. This cough is a common early sign of respiratory distress in pediatric patients with CF. It is essential for parents to recognize this symptom early on so that appropriate interventions and treatments can be initiated promptly. Option A) a barrel-shaped chest is associated with conditions like chronic obstructive pulmonary disease (COPD) rather than CF in pediatric patients. This is not a typical early respiratory symptom seen in CF. Option C) bronchiectasis is a complication that can develop over time in patients with CF due to recurrent lung infections and inflammation. It is not one of the early respiratory symptoms that parents should expect to see. Option D) wheezing respirations are more commonly associated with conditions like asthma rather than CF in pediatric patients. While wheezing can occur in CF, it is not typically one of the earliest respiratory symptoms seen in these patients. Educationally, understanding the early respiratory symptoms of CF is crucial for parents and caregivers to monitor and manage the condition effectively. By recognizing these symptoms early, parents can work closely with healthcare providers to develop a comprehensive care plan to optimize the respiratory health of their child with CF. Regular monitoring and early intervention can help improve outcomes and quality of life for pediatric patients with CF.

Correct Answer: A

Rationale: In the context of nursing interventions for pediatric respiratory distress, understanding proper positioning for newborns with specific conditions like exstrophy of the bladder is crucial. In this scenario, the correct answer is A) Prone. Rationale for the correct answer: Placing a newborn with exstrophy of the bladder in a prone position helps to prevent pressure on the bladder, reducing discomfort and potential complications. This position also allows for optimal lung expansion, aiding in respiratory function and oxygenation. Rationale for why others are wrong: - B) Supine position may increase pressure on the bladder, leading to potential complications and discomfort for the newborn. - C) Placing the newborn on either side does not specifically address the issue of bladder pressure and may not provide the necessary support for optimal respiratory function. - D) While elevating the head can be beneficial in some respiratory conditions, it does not directly address the specific needs of a newborn with exstrophy of the bladder. Educational context: Understanding the rationale behind positioning in pediatric patients with unique conditions is essential for nurses to provide safe and effective care. By knowing the rationale for specific positions, nurses can optimize patient outcomes and prevent potential complications. This knowledge is critical in pediatric nursing, where proper positioning can significantly impact respiratory function and overall well-being.

Correct Answer: C

Rationale: In the context of pediatric respiratory distress, understanding laboratory values that support a diagnosis of pyelonephritis is crucial for nurses to provide comprehensive care. The correct answer is C) Pyuria, which refers to the presence of pus in the urine and is a common indicator of urinary tract infections, including pyelonephritis. Pyuria is specifically associated with infections of the kidneys and urinary tract, making it a reliable marker for pyelonephritis diagnosis. The presence of white blood cells in the urine indicates an inflammatory response to the infection in the renal system. Regarding the incorrect options: A) Myoglobinuria is the presence of myoglobin in the urine, typically seen in conditions like rhabdomyolysis, not pyelonephritis. B) Ketonuria is the presence of ketones in the urine, often seen in conditions like diabetic ketoacidosis, not directly related to pyelonephritis. D) Low white blood cell count is not indicative of pyelonephritis, as infections typically lead to an increased white blood cell count due to the immune response. Educationally, understanding these laboratory values helps nurses differentiate between various conditions presenting with similar symptoms, enabling accurate assessment and timely interventions for pediatric patients with respiratory distress and suspected pyelonephritis. By grasping the significance of pyuria in this context, nurses can effectively contribute to the diagnostic process and subsequent treatment planning, improving patient outcomes.

Correct Answer: B

Rationale: Rationale: The correct answer is B) Hearing loss. In pediatric bacterial meningitis, hearing loss is the most common neurologic sequelae due to the inflammation and damage caused to the cochlea and auditory nerve by the infection. This can occur even with prompt treatment of the meningitis. Option A) Recurrent seizures are more commonly associated with conditions like epilepsy or head trauma rather than bacterial meningitis. Option C) Cognitive impairment may occur in bacterial meningitis, but it is not the most common neurologic sequelae; hearing loss takes precedence. Option D) Visual impairment is not a typical neurologic sequelae of bacterial meningitis in pediatric patients. Educational Context: Understanding the most common neurologic sequelae of bacterial meningitis in pediatric patients is crucial for nurses caring for these vulnerable populations. By recognizing the potential long-term effects such as hearing loss, healthcare providers can implement appropriate interventions and support for affected children and their families. This knowledge also underscores the importance of preventive measures such as vaccinations to reduce the incidence of meningitis and its complications.