Which disease of the following can cause distributive shock?

Correct Answer: C

Rationale: In pediatric nursing, understanding the causes of distributive shock is crucial for providing effective care to children in critical conditions. Distributive shock is characterized by widespread vasodilation leading to poor tissue perfusion. Among the options provided, the correct answer is C) Early septic shock. Septic shock, especially in its early stages, can cause distributive shock in children. This is due to the body's overwhelming immune response to infection leading to vasodilation and decreased vascular resistance, resulting in inadequate tissue perfusion. Option A) Cardiac tamponade is incorrect as it causes obstructive shock by compressing the heart and impairing cardiac function, not distributive shock. Option B) Dehydration can lead to hypovolemic shock due to decreased blood volume, not distributive shock. Option D) Critical aortic stenosis causes obstructive shock by obstructing blood flow out of the heart, not distributive shock. Educationally, this question highlights the importance of recognizing early signs of septic shock in pediatric patients. Nurses must be vigilant in assessing for signs of infection and hemodynamic instability to intervene promptly and prevent the progression to distributive shock, which can lead to multi-organ dysfunction and poor outcomes in children.

Correct Answer: D

Rationale: In pediatric nursing, performing chest compressions correctly during infant CPR is crucial for achieving effective resuscitation outcomes. The correct answer, option D - with 2 fingers of one hand, is based on the anatomical considerations of infants. Infants have smaller chests and delicate rib cages compared to adults, requiring a different approach during chest compressions. Using 2 fingers of one hand allows for more precise and controlled pressure over the infant's sternum, ensuring proper compression depth without causing harm. This technique is recommended by the American Heart Association for infants requiring CPR. Option A, with the heel of one hand and the other hand on top of the first, is incorrect as it is the technique used for adult CPR. Applying this method to infants can lead to excessive force and potential injury. Option B, with the heel of one hand only, and option C, with 4 fingers of one hand, are also incorrect as they do not provide the appropriate pressure distribution needed for effective chest compressions on infants. Educationally, it is essential for pediatric nurses to be well-versed in the differences between adult and infant CPR techniques. Understanding the anatomical and physiological distinctions in pediatric patients is crucial for providing safe and effective care during emergencies. Proper training and regular practice in infant CPR techniques are essential for healthcare professionals working with pediatric populations.

Correct Answer: D

Rationale: In pediatric nursing, identifying early signs of shock is crucial for timely intervention. The correct answer is D) Tachycardia. Tachycardia, an abnormally fast heart rate, is a key early sign of shock in children. When the body is in shock, the heart beats faster to compensate for decreased blood flow and maintain organ perfusion. This physiological response helps to maintain blood pressure in the early stages of shock. Option A) Hypotension is a late sign of shock in pediatric patients. Children can maintain their blood pressure until shock is advanced, making hypotension a less reliable early indicator. Option B) Disturbed consciousness level is a nonspecific sign that can be seen in various conditions, not specific to shock in pediatric patients. Option C) Cheyne-Stokes breathing is a pattern of breathing characterized by alternating periods of deep, rapid breathing followed by periods of apnea. While this may be seen in some cases of shock, it is not as consistently present or reliable as tachycardia in early identification. Educational Context: Understanding the early signs of shock in pediatric patients is vital for nurses to initiate prompt treatment and prevent progression to severe shock. Regular training and practice on recognizing these signs through scenarios and case studies can enhance nurses' clinical judgment and decision-making skills in pediatric emergencies. Encouraging a systematic approach to assessing pediatric patients for signs of shock can improve patient outcomes and safety.

Correct Answer: B

Rationale: Tumor lysis syndrome (TLS) is a potential complication seen in pediatric patients with cancer undergoing treatment. When tumor cells break down rapidly, they release large amounts of potassium, phosphorus, and nucleic acids into the bloodstream. This can lead to metabolic abnormalities such as hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia. In the context of TLS, the correct answer is B) Hyperkalemia. This is because as tumor cells lyse, intracellular potassium is released into the bloodstream, leading to elevated serum potassium levels. Hyperkalemia can result in life-threatening cardiac arrhythmias and must be managed promptly. Now, let's discuss why the other options are incorrect: A) Hypernatremia: This is not typically associated with TLS. Hypernatremia refers to high sodium levels in the blood, often caused by dehydration or excessive sodium intake. C) Hypokalemia: Low potassium levels are not a characteristic finding in TLS. Hypokalemia can be caused by factors such as diuretic use or gastrointestinal losses. D) Hyponatremia: Similarly, low sodium levels are not a common feature of TLS. Hyponatremia can occur due to conditions like fluid overload or syndrome of inappropriate antidiuretic hormone secretion (SIADH). In an educational context, understanding the metabolic abnormalities associated with TLS is crucial for pediatric nurses caring for oncology patients. Recognizing the signs and symptoms of TLS, including hyperkalemia, allows for early intervention and prevention of potentially serious complications. Nurses play a vital role in monitoring patients for TLS risk factors and implementing appropriate interventions to ensure patient safety and optimal outcomes.

Correct Answer: C

Rationale: In hereditary spherocytosis, the correct answer is C) Autosomal recessive. This condition is inherited in an autosomal dominant pattern, meaning an individual only needs to inherit one copy of the defective gene from one parent to develop the condition. This is why option C is false. Option A) Splenectomy is the treatment of choice is a common management approach for hereditary spherocytosis to alleviate symptoms and complications associated with the condition. This option is incorrect as it is a valid treatment option. Option B) Gallstones are common is also true in hereditary spherocytosis due to the increased breakdown of red blood cells leading to bilirubin formation, which can contribute to gallstone formation. This option is incorrect as it is a common complication seen in individuals with this condition. Option D) Can be presented in neonates is also correct as hereditary spherocytosis can manifest in the neonatal period or early childhood. This option is incorrect as it accurately represents the presentation of the condition. Educational Context: Understanding the inheritance pattern, clinical manifestations, and management strategies for hereditary spherocytosis is crucial for pediatric nurses caring for patients with this condition. By recognizing the false statement among the options provided, nurses can enhance their knowledge and provide optimal care for pediatric patients with hereditary spherocytosis.