Which disease of the following can cause distributive shock?

Correct Answer: C

Rationale: In this question, the correct answer is C) Early septic shock. Distributive shock is a type of shock characterized by widespread vasodilation and impaired distribution of blood flow. Early septic shock is a common cause of distributive shock in pediatric patients. Option A) Cardiac tamponade is a type of obstructive shock caused by fluid accumulation in the pericardium, leading to compression of the heart. This does not cause distributive shock. Option B) Dehydration leads to hypovolemic shock due to a decrease in blood volume, not distributive shock. Option D) Critical aortic stenosis causes obstructive shock due to impairment of blood flow out of the heart, not distributive shock. Educationally, it is important for pediatric nurses to understand the different types of shock and their causes in order to provide prompt and effective care to pediatric patients in critical conditions. Recognizing the signs and symptoms of distributive shock, such as in early septic shock, is crucial for early intervention and improving patient outcomes. This knowledge helps pediatric nurses prioritize care and interventions based on the underlying cause of shock.

Correct Answer: D

Rationale: Performing chest compressions during cardiopulmonary resuscitation (CPR) of an infant is a critical skill that requires precision and knowledge of best practices. The correct answer, option D, "With 2 fingers of one hand," is based on the current guidelines recommended by the American Heart Association (AHA) for infant CPR. Using two fingers (index and middle fingers) allows for more targeted and appropriate pressure to be applied to the infant's small chest, which is essential for effective compressions to circulate blood and oxygen. Using the entire hand, as in option A, or just the heel of one hand, as in option B, may not provide adequate pressure or may cover too much surface area, leading to ineffective compressions. Option C, "With 4 fingers of one hand," is also incorrect because using four fingers may lead to uneven pressure distribution and potentially harm the infant's delicate chest. In an educational context, it is crucial for healthcare providers, especially those specializing in pediatric nursing, to be well-versed in the correct techniques for infant CPR to ensure the best outcomes in emergency situations. Understanding the rationale behind using two fingers for chest compressions in infants is vital for providing safe and effective care in pediatric emergencies. Practicing and mastering these skills through simulations and hands-on training can help healthcare professionals confidently respond to infant CPR scenarios.

Correct Answer: D

Rationale: In pediatric nursing, recognizing the early signs of shock is crucial for timely intervention. The correct answer is D) Tachycardia. In pediatric patients, tachycardia is often one of the earliest signs of shock. When the body is in a state of shock, the heart rate increases as a compensatory mechanism to maintain adequate tissue perfusion. Therefore, identifying tachycardia early can help healthcare providers intervene promptly to prevent further deterioration. Option A) Hypotension is a late sign of shock in pediatric patients. Children can maintain their blood pressure until shock is quite advanced, making hypotension a less reliable early indicator compared to tachycardia. Option B) Disturbed consciousness level is a significant finding in shock, but it usually occurs in the later stages when the brain is deprived of adequate perfusion. Option C) Cheyne-Stokes breathing is a pattern of breathing characterized by alternating periods of deep, rapid breathing followed by periods of apnea. While it can be seen in some cases of shock, it is not as specific or early of a sign as tachycardia in pediatric patients. For educational context, understanding the progression of shock symptoms in pediatric patients is essential for nurses caring for this vulnerable population. By knowing the early signs like tachycardia, nurses can initiate appropriate interventions promptly, potentially preventing further deterioration and improving outcomes for pediatric patients in shock.

Correct Answer: B

Rationale: Tumor lysis syndrome (TLS) is a potentially life-threatening oncologic emergency characterized by the rapid release of intracellular contents into the bloodstream following cancer treatment. One of the metabolic abnormalities associated with TLS is hyperkalemia, making option B the correct answer. Hyperkalemia occurs in TLS due to the release of potassium from lysed tumor cells, overwhelming the body's ability to excrete it. This can lead to dangerous cardiac arrhythmias and other complications if not promptly managed. The other options - hypernatremia (A), hypokalemia (C), and hyponatremia (D) - are not typically associated with tumor lysis syndrome. Hypernatremia and hyponatremia involve disturbances in sodium levels, while hypokalemia is a low potassium level, which is the opposite of what is expected in TLS. In an educational context, understanding the metabolic abnormalities associated with tumor lysis syndrome is crucial for nurses caring for pediatric oncology patients. Recognizing the signs and symptoms of TLS, including hyperkalemia, allows for early intervention and prevention of severe complications. Nurses play a vital role in monitoring patients undergoing cancer treatment for TLS and must be knowledgeable about the potential metabolic disturbances that may arise.

Correct Answer: C

Rationale: In hereditary spherocytosis, the correct answer is C) Autosomal recessive. This condition is inherited in an autosomal dominant pattern, which means that one copy of the altered gene in each cell is sufficient to cause the disorder. Therefore, the presence of a single altered gene is enough to manifest the condition. Option A) Splenectomy is the treatment of choice: While splenectomy is a common treatment for hereditary spherocytosis to alleviate symptoms, it is not the only treatment option. Folic acid supplementation and supportive care are also important in managing the condition. Option B) Gallstones are common: Gallstones are indeed common in individuals with hereditary spherocytosis due to the increased breakdown of red blood cells leading to bilirubin accumulation. This can result in the formation of gallstones, which may require intervention. Option D) Can be presented in neonates: Hereditary spherocytosis can indeed present in neonates, with symptoms such as anemia and jaundice becoming apparent early in life. It is crucial for healthcare providers to be aware of this possibility to provide timely diagnosis and management. Educational context: Understanding the genetic inheritance pattern of hereditary spherocytosis is essential for healthcare providers working with pediatric patients. Recognizing the false statement in this question helps reinforce the knowledge of autosomal dominant inheritance in hereditary spherocytosis, while also highlighting key aspects of its presentation and management. This information is vital for nurses specializing in pediatric care to deliver comprehensive and effective patient care.