Which compensatory mechanism occurs in bicarbonate loss in urine?

Correct Answer: C

Rationale: In cases of bicarbonate loss in urine, the compensatory mechanism that occurs is hyperventilation, as indicated by option C. When bicarbonate is lost in the urine, the body tries to maintain acid-base balance by increasing ventilation to blow off carbon dioxide, which helps to decrease acidity in the blood. Option A, extracellular shift of potassium, is not the correct answer because it does not directly relate to compensating for bicarbonate loss. Potassium shifts are more commonly seen in conditions like metabolic alkalosis. Option B, reduction in urine output, is not the correct answer either. While changes in urine output can occur in response to various conditions, it is not the compensatory mechanism for bicarbonate loss in urine. Option D, loss of organic acids in urine, is also incorrect. This choice does not address the specific compensatory mechanism needed to balance bicarbonate loss. In an educational context, understanding the compensatory mechanisms in acid-base imbalances is crucial for pediatric nurses to provide effective care for children with various health conditions. By knowing how the body responds to disturbances in acid-base balance, nurses can monitor patients effectively, intervene promptly, and collaborate with the healthcare team to restore equilibrium. This knowledge ensures optimal patient outcomes and safety in pediatric healthcare settings.

Correct Answer: D

Rationale: In pediatric practice, diagnosing and managing hypertension is crucial for early intervention and long-term health outcomes. Stage 1 hypertension in children is defined as average SBP or DBP levels between the 95th and 99th percentiles for age, sex, and height on at least three separate occasions. Option A is incorrect because having average levels below the 90th percentile would not meet the criteria for stage 1 hypertension. Option B is also wrong as having levels above the 99th percentile would indicate severe hypertension, not stage 1. Option C, BP > 120/80, is a general reference point for adult hypertension and does not align with pediatric guidelines. Understanding these definitions is vital for pediatric nurses to accurately identify and manage hypertension in children. By recognizing the correct range for stage 1 hypertension, nurses can initiate appropriate interventions, educate families on lifestyle modifications, and collaborate with healthcare providers for further evaluation and treatment. This knowledge ensures comprehensive care and optimal outcomes for pediatric patients at risk for hypertension-related complications.

Correct Answer: D

Rationale: In this question, the correct answer is D) Large atrial septal defect. A large atrial septal defect poses the least risk of developing infective endocarditis among the options provided. This is because the blood flow through a large atrial septal defect is typically not turbulent enough to cause endothelial damage, reducing the likelihood of bacterial colonization and subsequent infection. Option A) Small ventricular septal defect, option B) Severe aortic regurgitation, and option C) Severe mitral regurgitation all involve turbulent blood flow across the defect or valve, leading to endothelial damage. This damage creates a conducive environment for bacteria to adhere and cause infective endocarditis. Educationally, understanding the relationship between the size of the defect/regurgitation and the risk of infective endocarditis is crucial for pediatric nurses. It highlights the importance of monitoring and managing congenital heart defects and valvular issues to prevent complications such as infective endocarditis. Nurses need to assess and educate patients and families on the risks associated with different cardiac conditions to provide comprehensive care.

Correct Answer: C

Rationale: In the context of pediatric nursing, it is crucial to differentiate between signs of active rheumatic fever to ensure accurate diagnosis and appropriate treatment. The correct answer, option C, "Persistent joint symptoms," is not typically associated with active rheumatic fever. Option A, "New significant murmur of mitral or aortic valvulitis," is a common sign of active rheumatic fever due to valvular damage. Option B, "High CRP," is also indicative of inflammation, which is often elevated in active rheumatic fever. Option D, "High anti-streptolysin O titer," is a marker of recent streptococcal infection, which can lead to rheumatic fever. Educationally, understanding the clinical manifestations of rheumatic fever is essential for pediatric nurses to provide quality care. Recognizing the signs and symptoms helps in early detection, prompt intervention, and preventing complications. By grasping the nuances between different signs, nurses can contribute to improved patient outcomes and overall healthcare quality in pediatric settings.

Correct Answer: B

Rationale: In the context of pediatric nursing and rheumatic fever, understanding the features of polyarthritis is crucial for accurate diagnosis and treatment. The correct answer is option B: Equally affect large and small joints. In acute rheumatic fever, polyarthritis typically affects larger joints such as the knees, ankles, elbows, and wrists, rather than equally affecting large and small joints. Option A, polyarticular and migratory, is correct as polyarthritis in acute rheumatic fever presents with inflammation in multiple joints that shift from one joint to another over a short period of time. Option C is incorrect as the commonest major manifestation in children with the initial attack of acute rheumatic fever is carditis, not polyarthritis. Option D is incorrect because polyarthritis in acute rheumatic fever is not always associated with positive serological evidence of recent streptococcal infection. Educationally, this question highlights the importance of recognizing the clinical features of acute rheumatic fever, particularly polyarthritis, in pediatric patients. Nurses need to be familiar with the typical joint involvement patterns to differentiate acute rheumatic fever from other conditions and provide appropriate care. Understanding these distinctions can lead to timely interventions and improved outcomes for pediatric patients with rheumatic fever.