What is the maximum accepted rate of drop of serum sodium per 24 hours in hypernatremia?

Correct Answer: A

Rationale: In pediatric nursing, understanding the management of hypernatremia is crucial for providing safe and effective care to children. The correct answer to the question is A) 8 mmol/L. The maximum accepted rate of drop of serum sodium per 24 hours in hypernatremia is generally recommended to be around 8-10 mmol/L to prevent the risk of cerebral edema and other serious complications. Rapid correction of hypernatremia can lead to osmotic demyelination syndrome, especially in children, making it essential to correct hypernatremia at a controlled rate. Option B) 12 mmol/L is incorrect because this rate of drop in serum sodium is higher than the recommended safe range, increasing the risk of neurological complications. Option C) 16 mmol/L and Option D) 20 mmol/L are also incorrect as they represent even higher rates of drop in serum sodium, which could be dangerous and lead to adverse effects on the brain and other organs. Educationally, this question highlights the importance of understanding the delicate balance in correcting electrolyte imbalances, especially in pediatric patients. Nursing professionals need to be aware of the recommended guidelines for correcting hypernatremia to prevent complications and ensure the best outcomes for their young patients. By knowing the safe parameters for correcting hypernatremia, nurses can provide quality care and advocate for the well-being of children in their care.

Correct Answer: B

Rationale: The correct answer is B) Expelling a foreign body in an unconscious child. The Heimlich maneuver is a first aid procedure used to dislodge an obstruction from a person's airway when they are choking and unable to breathe or speak. In pediatric nursing, this maneuver is crucial as children are at higher risk of choking due to their smaller airways and tendency to put objects in their mouths. Performing the Heimlich maneuver correctly can save a child's life by quickly removing the obstruction and restoring their ability to breathe. Option A) Assessing if the child is breathing is incorrect because the Heimlich maneuver is not used for assessment but for actively removing a foreign body obstructing the airway. Option C) Chest compression in a large child is incorrect as chest compressions are part of CPR (Cardiopulmonary Resuscitation) and are not performed during the Heimlich maneuver. Option D) Opening the airway in possible cervical spine injury is incorrect because the Heimlich maneuver is specifically for choking emergencies and not intended for managing cervical spine injuries. Educationally, it is important for pediatric nurses to be well-versed in the correct techniques for emergency procedures like the Heimlich maneuver to respond effectively in critical situations. Regular training, practice drills, and staying updated on pediatric first aid guidelines are essential to ensure nurses can provide prompt and accurate care to children in need.

Correct Answer: C

Rationale: In pediatric nursing, the administration of drugs during resuscitation is crucial to support a child's life. In this question, the correct answer is C) Digitalis. Digitalis is not used during resuscitation in pediatric patients. Atropine (A) is used to treat symptomatic bradycardia in pediatric patients. Bicarbonate (B) may be used in certain cases of metabolic acidosis during resuscitation. Epinephrine (D) is a key medication in pediatric resuscitation as it helps improve cardiac output and blood pressure during cardiac arrest. Educationally, understanding which drugs are appropriate for pediatric resuscitation scenarios is vital for nursing practice. Knowledge of each drug's indication, dosage, and potential side effects is essential to ensure safe and effective care for pediatric patients in critical situations. This question reinforces the importance of precise medication administration in pediatric resuscitation and highlights the need for nurses to be well-versed in pharmacology to deliver high-quality care.

Correct Answer: D

Rationale: The correct answer is D) Metabolic alkalosis without compensation. This interpretation is based on the given ABG results: pH 7.48 (alkalotic), PaCO2 42 (normal), and HCO3 30 (elevated). In metabolic alkalosis, there is an excess of bicarbonate (HCO3) in the blood, leading to an increase in pH above the normal range (7.35-7.45). The normal PaCO2 in this case indicates that there is no compensatory respiratory response to the metabolic alkalosis, hence "without compensation." Option A) Metabolic acidosis without compensation is incorrect because the pH is alkalotic, not acidic. Option B) Respiratory alkalosis with partial compensation is incorrect because the PaCO2 is normal, not low, and there is no compensatory respiratory response. Option C) Respiratory alkalosis with full compensation is incorrect for the same reasons as option B. Understanding ABG results is crucial in pediatric nursing as it helps in assessing a child's acid-base balance, respiratory function, and overall oxygenation status. Recognizing different acid-base imbalances is essential for appropriate diagnosis and treatment in pediatric patients. Remembering the normal ranges for pH, PaCO2, and HCO3, as well as the relationships between them, is key to interpreting ABGs accurately.

Correct Answer: D

Rationale: In pediatric nursing, understanding acid-base balance is crucial for providing effective care to patients, especially those with renal failure. In this scenario, the correct answer is D) Wide anion gap. Wide anion gap acidosis in renal failure is typically due to the accumulation of unmeasured anions like phosphates, sulfates, and organic acids. This occurs because the kidneys are unable to excrete these acids, leading to an increase in the anion gap. Option A) Hypochloremia is unlikely as renal failure would lead to the retention of chloride ions, causing hyperchloremia rather than hypochloremia. Option B) Hypokalemia is also unlikely as renal failure often results in hyperkalemia due to the impaired excretion of potassium by the kidneys. Option C) Hypernatremia is less likely to be associated with acidosis in renal failure as it is more commonly seen in conditions like dehydration or excessive sodium intake. Understanding the relationship between renal failure and acid-base balance is essential for pediatric nurses to assess, plan, and intervene effectively in the care of their patients. By grasping these concepts, nurses can make informed clinical decisions to manage acidosis in children with renal impairment, ensuring optimal patient outcomes.