The nurse is teaching the family of a child with a long-term central venous access device about signs and symptoms of bacteremia. What finding indicates the presence of bacteremia?

Correct Answer: C

Rationale: The correct answer is C) Fever and general malaise. When a child with a long-term central venous access device develops bacteremia, it commonly presents with fever and general malaise. This is a hallmark sign as the body responds to the presence of bacteria in the bloodstream by increasing the temperature to fight the infection. General malaise, which includes symptoms such as fatigue, weakness, and overall feeling unwell, is also commonly observed due to the body's response to the infection. Option A) Hypertension is incorrect because bacteremia typically does not cause hypertension. Infection-related hypertension is not a common sign of bacteremia in children with central venous access devices. Option B) Pain at the entry site is incorrect because localized pain is more suggestive of a local infection at the entry site rather than systemic bacteremia. While pain can sometimes be present with bacteremia, it is usually not the primary or most consistent symptom. Option D) Redness and swelling at the entry site is incorrect because these signs indicate a local infection at the site of the central venous access device rather than systemic bacteremia. While redness and swelling can sometimes be seen with bacteremia, they are not the primary indicators; fever and general malaise are more indicative of systemic infection spreading through the bloodstream. In an educational context, it is crucial for nurses to understand the signs and symptoms of bacteremia in children with central venous access devices. Recognizing these signs promptly can lead to early intervention and prevent further complications. Educating families about these signs empowers them to monitor their child's condition closely and seek medical attention promptly if any concerning symptoms arise.

Correct Answer: C

Rationale: In this question, the correct answer is C) Giardia lamblia. Giardia lamblia is a parasite that causes acute diarrhea in children. It is important for nursing students to understand this because parasitic infections can present with specific symptoms and require targeted treatment. Giardia lamblia is commonly associated with contaminated water sources and can cause significant gastrointestinal issues in children. Option A) Shigella organisms typically cause bacillary dysentery, which is characterized by bloody diarrhea and abdominal cramps. While Shigella can cause diarrhea, it is not a parasite. Option B) Salmonella organisms are usually associated with foodborne infections that can lead to diarrhea, fever, and abdominal pain. Salmonella is a bacterium, not a parasite. Option D) Escherichia coli can also cause diarrhea, but it is a bacterium rather than a parasite. Some strains of E. coli can cause severe gastrointestinal illness, but they are not classified as parasites. Understanding the differences between various pathogens that can cause diarrhea is crucial for nurses caring for children, as it helps in accurate diagnosis and appropriate treatment selection. By knowing the specific characteristics of different organisms, nurses can provide effective care and educate families on prevention strategies.

Correct Answer: B

Rationale: In children, the most frequent cause of hypovolemic shock is blood loss. This is because children have a smaller blood volume compared to adults, so even a relatively small amount of blood loss can quickly lead to significant hypovolemia and shock. Sepsis (option A) can also cause shock, but it is not as common a cause in children as blood loss. Anaphylaxis (option C) is more likely to cause distributive shock rather than hypovolemic shock. Heart failure (option D) can lead to cardiogenic shock, not hypovolemic shock. Educationally, understanding the primary causes of hypovolemic shock in children is crucial for nurses caring for pediatric patients. Recognizing the signs and symptoms of hypovolemic shock, along with its common causes, allows nurses to intervene promptly and effectively to stabilize the child's condition. This knowledge is essential for providing safe and competent care to pediatric patients in various healthcare settings.

Correct Answer: D

Rationale: The correct answer is D) Anaphylactic shock. Anaphylactic shock is characterized by a hypersensitivity reaction that leads to massive vasodilation and capillary leaks. In cases of severe allergic reactions, such as those triggered by drugs or latex, the body releases large amounts of histamine and other inflammatory substances, causing widespread blood vessel dilation and increased permeability of capillaries. This results in a drop in blood pressure, compromised tissue perfusion, and potentially life-threatening complications. Option A) Neurogenic shock is caused by spinal cord injury or trauma, leading to widespread vasodilation due to loss of sympathetic tone. This is not related to hypersensitivity reactions like in the given scenario. Option B) Cardiogenic shock is due to heart failure, where the heart is unable to pump effectively, leading to poor tissue perfusion. This is not related to the mechanisms of anaphylactic shock. Option C) Hypovolemic shock occurs due to a significant loss of blood or fluid volume, leading to decreased circulating volume and subsequent inadequate tissue perfusion. While it is important to consider in cases of shock, it does not match the pathophysiology described in the question. In an educational context, understanding the different types of shock and their underlying mechanisms is crucial for nurses caring for children. Recognizing the signs and symptoms of anaphylactic shock, such as hives, swelling, difficulty breathing, and hypotension, is essential for prompt intervention and management. Nurses should be prepared to administer epinephrine, provide airway support, and initiate fluid resuscitation as part of the emergency treatment for anaphylaxis. This knowledge and preparedness can make a significant difference in the outcomes for children experiencing severe allergic reactions.

Correct Answer: D

Rationale: In the context of pediatric shock, the correct answer is D) Confusion and somnolence because as shock progresses and becomes decompensated, the child's body is no longer able to compensate for the inadequate tissue perfusion. This leads to a decreased level of consciousness, confusion, and eventually somnolence as the brain becomes severely hypoperfused. Option A) Thirst is an early sign of shock, not a late manifestation seen in decompensated shock. Option B) Irritability and C) Apprehension are also early signs of shock due to sympathetic nervous system activation, but as shock worsens, the child's mental status shifts from agitation to confusion and eventually somnolence. Educationally, understanding the progression of shock symptoms is crucial for nurses caring for pediatric patients. Recognizing the signs of decompensated shock promptly is essential to initiate appropriate interventions and prevent further deterioration. Monitoring for changes in mental status, along with vital signs and perfusion parameters, is vital in the assessment and management of pediatric patients in shock.