Which best describes the electrolyte imbalance in chronic renal failure (CRF)?

Correct Answer: B

Rationale: In chronic renal failure (CRF), the correct answer is B) Depletion of calcium and phosphorus from the bones due to hypocalcemia. In CRF, the kidneys are unable to regulate electrolyte balance effectively, leading to impaired excretion of phosphorus and decreased activation of vitamin D, which in turn causes hypocalcemia. This results in the body attempting to maintain normal serum calcium levels by leaching calcium and phosphorus from the bones, leading to bone demineralization and osteoporosis. Option A is incorrect because in CRF, there is typically an increase in serum phosphorus levels due to decreased excretion by the kidneys. Option C is incorrect as calcium does not remain in the bones due to a structural change; rather, the bones are depleted of calcium and phosphorus. Option D is incorrect as poor nutritional intake does not directly lead to decreased electrolytes in CRF; the primary issue lies in the kidney's inability to regulate electrolyte balance efficiently. Understanding the electrolyte imbalances in CRF is crucial for pediatric genitourinary nursing interventions as these imbalances can have significant effects on a child's growth, development, and overall health. Nurses need to closely monitor and manage these electrolyte abnormalities to prevent complications such as bone disease and metabolic disturbances in pediatric patients with CRF.

Correct Answer: C

Rationale: In the context of pediatric genitourinary nursing interventions, understanding the laboratory results associated with hemolytic uremic syndrome (HUS) is crucial for timely and effective management. The correct answer is option C: Mild proteinuria, increased BUN and creatinine. The presence of mild proteinuria in HUS is due to the damage caused to the glomerular filtration barrier, allowing some proteins to pass through into the urine. Elevated blood urea nitrogen (BUN) and creatinine levels indicate impaired kidney function, which is a hallmark of HUS due to the systemic effects of the condition on the kidneys. Option A (Massive proteinuria, elevated BUN and creatinine) is incorrect because massive proteinuria is not typically seen in HUS. Option B (Mild proteinuria, decreased BUN and creatinine) is also incorrect as HUS leads to increased, not decreased, BUN and creatinine levels. Option D (Massive proteinuria, decreased BUN and creatinine) is incorrect as well due to the reasons mentioned above. Educationally, this question highlights the importance of recognizing the specific pattern of laboratory abnormalities in HUS, enabling nurses to promptly identify and intervene in the care of pediatric patients with this condition. Understanding these nuances can lead to improved patient outcomes and effective nursing interventions.

Correct Answer: A

Rationale: In the case of an 8-year-old who has just undergone an appendectomy for a ruptured appendix, the best position for the child is A) Right side-lying. This position helps to promote drainage from the surgical site and reduce the risk of complications such as wound infection or abscess formation. Placing the child in a right side-lying position also helps to prevent the child from putting undue pressure on the surgical site, allowing for better healing. The other options are not appropriate for this specific post-appendectomy scenario: - B) Semi-Fowler position: While this position is commonly used to promote respiratory function and reduce the risk of aspiration in other situations, it is not the optimal choice for a child recovering from an appendectomy due to the need to promote drainage and prevent pressure on the surgical site. - C) Prone position: Placing the child in a prone position would not be ideal after an appendectomy as it could potentially put pressure on the surgical site and interfere with proper drainage and healing. - D) Left side-lying position: While side-lying positions can help with comfort and prevent complications in certain scenarios, in the case of a post-appendectomy situation, the right side-lying position is preferred due to its specific benefits for drainage and healing. Educationally, understanding the rationale behind positioning post-surgery is crucial for pediatric nurses to provide optimal care for their patients. Implementing the correct positioning can significantly impact the child's recovery, prevent complications, and promote overall well-being. It is essential for nurses to have a strong foundation in pediatric nursing interventions, including proper positioning techniques, to ensure the best outcomes for their patients.

Correct Answer: C

Rationale: In this scenario, the correct immediate action for the nurse is option C: Take the infant from the mother, place the infant in the crib for assessment, and immediately obtain oxygen saturation while administering blow-by oxygen. The rationale behind this choice is based on the infant's symptoms of coughing, choking, and cyanosis, indicating a potential respiratory distress or airway obstruction during feeding. The nurse must act swiftly to ensure the infant's safety and well-being. Placing the infant in a safe environment, assessing the oxygen saturation level, and providing oxygen support are crucial steps in managing this emergency situation. Option A is incorrect because informing the physician may cause a delay in providing the necessary immediate care to the infant. Option B is also incorrect as simply observing without taking prompt action can be dangerous for the infant in distress. Option D is not appropriate as continuing feeding can exacerbate the respiratory distress the infant is experiencing. This scenario highlights the importance of pediatric nursing interventions in recognizing and responding to respiratory distress in newborns. Nurses must be prepared to act quickly and decisively in such situations to ensure optimal outcomes for their pediatric patients.

Correct Answer: B

Rationale: In pediatric genitourinary nursing interventions, understanding the reabsorption of bicarbonate in the renal system is crucial for managing acid-base balance in children. The correct answer is B) proximal tubule. Rationale for B) Proximal Tubule: The proximal tubule is responsible for reabsorbing approximately 75% of the filtered bicarbonate in the kidney. This process is essential for maintaining acid-base balance in the body. The proximal tubule is highly efficient in reabsorbing bicarbonate to help regulate pH levels in the blood and prevent acidosis. Rationale for why others are wrong: A) Juxtaglomerular Apparatus: The juxtaglomerular apparatus is involved in regulating blood pressure and the filtration rate of the kidneys, not in the reabsorption of bicarbonate. C) Loop of Henle: The loop of Henle is responsible for concentrating urine and reabsorbing water, sodium, and chloride, but not for reabsorbing bicarbonate. D) Distal Tubule: The distal tubule plays a role in fine-tuning electrolyte balance by reabsorbing sodium and water, but it is not the primary site for bicarbonate reabsorption. Educational context: Understanding the specific renal processes involved in maintaining acid-base balance is crucial for pediatric nurses caring for children with renal disorders or imbalances. Knowledge of where bicarbonate reabsorption occurs in the kidney helps nurses assess, monitor, and intervene effectively in pediatric patients with acid-base disturbances. This knowledge also informs appropriate nursing interventions and treatments aimed at restoring acid-base equilibrium in pediatric patients.