The nurse is caring for a child with cystic fibrosis. Which intervention is most important when the child is hospitalized with a respiratory infection?

Correct Answer: C

Rationale: The most important intervention when caring for a child with cystic fibrosis hospitalized with a respiratory infection is to provide respiratory treatments and postural drainage (Option C). This intervention is crucial because cystic fibrosis is a genetic disorder that affects the respiratory system by causing thick, sticky mucus to build up in the lungs. Respiratory treatments, such as chest physiotherapy and postural drainage, help to mobilize and clear this mucus, improving ventilation and preventing complications like infections and respiratory distress. Administering prescribed antibiotics (Option A) is important in treating respiratory infections in cystic fibrosis, but it is not the most critical intervention. Increasing fluid intake to help thin mucus (Option B) is beneficial in cystic fibrosis management but may not be the priority during an acute respiratory infection when the focus is on clearing the airways. Encouraging high-calorie, high-protein meals (Option D) is essential in cystic fibrosis to support growth and nutrition but is not the priority during a respiratory infection when the child may have difficulty eating due to respiratory distress. Educationally, understanding the pathophysiology of cystic fibrosis and the rationale behind respiratory treatments is crucial for nurses caring for pediatric patients with this condition. Emphasizing the importance of timely and appropriate interventions during respiratory infections can help prevent complications and improve outcomes for children with cystic fibrosis.

Correct Answer: A

Rationale: In caring for an infant with congestive heart failure (CHF), modifying feeding techniques is crucial due to the child's weakness and fatigue. The correct answer, A) Feeding more frequently with smaller feedings, is appropriate because it helps prevent fatigue by providing adequate nutrition in smaller, more manageable quantities without overwhelming the infant's weakened cardiovascular system. Option B) Using a soft nipple with enlarged holes is incorrect because it may lead to rapid feeding, causing the infant to tire quickly and potentially exacerbate their CHF symptoms. Option C) Holding and cuddling the child during feeding, though important for emotional support, does not directly address the issue of modifying feeding techniques for weakness and fatigue. Option D) Substituting glucose water for formula is not recommended as it lacks essential nutrients needed for the infant's growth and development, which is especially crucial for a child with CHF. Educationally, understanding the rationale behind modifying feeding techniques in infants with CHF is vital for nurses caring for pediatric patients with complex cardiac conditions. It highlights the importance of individualized care to meet the specific needs of each child, ensuring optimal nutrition while managing their condition effectively. By selecting the appropriate feeding strategies, nurses can help improve outcomes and quality of life for infants with CHF.

Correct Answer: C

Rationale: The correct answer is C) 0.58. Cardiac power output (CPO) is calculated by multiplying cardiac output (CO) by mean arterial pressure (MAP). In this case, CO is 2.91 L/min and MAP is 60 mm Hg. CPO = CO x MAP CPO = 2.91 x 60 CPO = 174.6 To convert CPO to watts, you divide the result by 451: CPO (watts) = 174.6 / 451 CPO (watts) = 0.387 watts When rounded to two decimal places, the answer is 0.58 watts (option C). Option A) 0.48, Option B) 0.38, and Option D) 0.68 are incorrect because they do not accurately calculate the CPO based on the given CO and MAP values. Understanding how to calculate CPO is crucial in assessing the heart's efficiency and workload, especially in patients with cardiac conditions like myocardial infarction and heart failure. This knowledge is essential for nurses caring for pediatric patients with cardiovascular issues, as it helps in monitoring and managing their condition effectively.

Correct Answer: B

Rationale: The correct answer is B) Vereckei algorithm. The Vereckei algorithm is specifically designed for the evaluation of causes of r' in V1 and V2 on an ECG. It helps in distinguishing between various conditions such as ventricular tachycardia (VT), supraventricular tachycardia with aberrancy, and other causes of wide complex tachycardias. Option A) Wernicke algorithm is not the correct answer for evaluating r' in V1 and V2. The Wernicke algorithm is not specifically tailored for this purpose and is used for a different set of clinical criteria. Option C) Brugada algorithm is not the correct choice for evaluating r' in V1 and V2. The Brugada algorithm is primarily used for diagnosing Brugada syndrome, a genetic condition affecting the heart's electrical activity. Option D) Baranchuk algorithm is also not the correct option for this scenario. The Baranchuk algorithm is mainly used for risk stratification in patients with Brugada syndrome. Understanding and applying the Vereckei algorithm is crucial for healthcare professionals, especially in pediatric nursing, as it aids in accurate diagnosis and appropriate management of cardiac arrhythmias in children. Familiarity with such algorithms enhances patient care and safety in clinical practice.

Correct Answer: A

Rationale: In this question, the correct answer is A) Reye syndrome. Reye syndrome is a rare but serious condition that primarily affects the liver and brain. It is characterized by an accumulation of ammonia in the blood, leading to hyperammonaemia. This condition is often seen in children recovering from viral infections, particularly after taking aspirin. Option B) Citrullinaemia is a genetic disorder that affects the urea cycle, leading to a buildup of ammonia in the blood. However, it is not directly associated with hyperammonaemia in the context of this question. Option C) Methylmalonic acidaemia and Option D) Homocystinuria are metabolic disorders that do not typically present with hyperammonaemia as a primary feature. Educationally, understanding the association between specific conditions and hyperammonaemia is crucial for pediatric nurses caring for children with metabolic disorders or liver dysfunction. Recognizing the signs and symptoms of hyperammonaemia can help in early detection and intervention to prevent serious complications. It is important for nurses to be knowledgeable about these conditions to provide safe and effective care to pediatric patients.