Which information should the nurse know when caring for a child with Kawasaki disease?

Correct Answer: D

Rationale: High-dose IV gamma globulin and aspirin therapy is indicated to reduce the incidence of coronary artery abnormalities when given within the first 10 days of the illness. The fever of Kawasaki disease is unresponsive to antibiotics and antipyretics. Mucous membranes, conjunctiva, changes in the extremities, and cardiac involvement are seen. Aspirin is part of the therapy.

Correct Answer: D

Rationale: In this question, the correct answer is D) Fabry disease. Maltese crosses are lipid-laden tubular epithelial cell casts seen in the urine sediment of patients with Fabry disease. This finding is due to the accumulation of globotriaosylceramide in the lysosomes of renal tubular cells. Option A) Niemann Pick disease is incorrect because it presents with foam cells in the bone marrow, liver, and spleen, not Maltese crosses in the urine. Option B) Gaucher disease is incorrect as it presents with Gaucher cells (lipid-laden macrophages), not Maltese crosses in the urine sediment. Option C) Krabbe's disease is incorrect as it is a lysosomal storage disorder that results in the accumulation of galactocerebroside, not leading to the presence of Maltese crosses in the urine. Educationally, understanding the specific urine sediment findings in different diseases is crucial for healthcare professionals, especially in diagnosing and managing rare conditions like Fabry disease. Connecting these findings to the underlying pathophysiology helps in clinical decision-making and providing appropriate care to patients.

Correct Answer: B

Rationale: The correct answer is B) Impaired fine motor movement and poor coordination are 'soft' but specific signs of ADHD. This statement is false as fine motor movement and coordination difficulties are not specific to ADHD but can be present in other neurodevelopmental disorders as well. A) The statement about the involvement of the Dopamine transporter gene (DAT1) and dopamine 4 receptor gene (DRD4) in ADHD diagnosis is true. These genes have been implicated in the pathophysiology of ADHD. C) The statement that developmentally inappropriate behavior must begin before 7 years of age and persist for at least 6 months is true. This criterion is essential for diagnosing ADHD in children. D) Maternal lead exposure being associated with ADHD is also a true statement. Environmental factors, such as lead exposure, have been linked to an increased risk of developing ADHD in children. Educational Context: Understanding the diagnostic criteria and associated factors of ADHD is crucial for healthcare professionals, especially those working with pediatric populations. By differentiating between true and false statements related to ADHD, nurses can provide better care and support for children with this condition. It also highlights the importance of comprehensive assessments and considering various factors in diagnosing and managing ADHD in pediatric patients.

Correct Answer: C

Rationale: In the scenario presented, the most appropriate initial treatment for the 18-month-old infant experiencing acute anaphylaxis with bronchospasm towards antibiotic injection is option C) Inj. Epinephrine 0.01 mg IV/IM stat. This is the correct choice because epinephrine is the first-line treatment for anaphylaxis, especially when there is respiratory compromise such as bronchospasm. In this pediatric case, the dose of epinephrine is weight-based (0.01 mg/kg), making it the most suitable option for this 10 kg infant. Option A) Inj. Hydrocortisone 100 mg IV stat is not the most appropriate initial treatment in this acute situation. While corticosteroids like hydrocortisone play a role in the management of anaphylaxis, they are not the first-line treatment for acute bronchospasm and should be administered after epinephrine. Option B) Inj. Epinephrine 0.1 mg IV/IM stat is a higher dose than recommended for this infant's weight and age. Using this higher dose could lead to adverse effects, especially in pediatric patients. Option D) Nebulization Salbutamol + oxygen is not the most appropriate initial treatment for acute anaphylaxis with bronchospasm. While bronchodilators like salbutamol can help with bronchospasm, epinephrine remains the first-line treatment due to its broader effects in anaphylactic reactions. Educationally, it is crucial for healthcare providers to understand the principles of managing anaphylaxis, especially in pediatric patients. Knowing the correct dosages and medications for different age groups is essential to provide safe and effective care in such critical situations. Weight-based dosing is particularly crucial in pediatrics to avoid medication errors and ensure optimal outcomes for the patient.

Correct Answer: C

Rationale: In the context of recurrent Neisserial meningitis in children, the correct answer is C) C8. This is because a deficiency in C8 leads to impaired formation of the membrane attack complex (MAC), which plays a crucial role in the host defense against Neisseria species. The MAC is responsible for creating pores in the bacterial cell membrane, ultimately leading to bacterial lysis and destruction. Option A) C3 and option B) C4 are incorrect because deficiencies in these components would not directly impact the formation of the MAC, which is critical in combating Neisseria infections. Option D) All is also incorrect as the specific deficiency linked to recurrent Neisserial meningitis is that of C8, not all complement components. Educationally, understanding the role of the complement system in immune defense is crucial for healthcare professionals, especially in the context of infectious diseases like Neisserial meningitis. This knowledge aids in proper diagnosis, treatment, and prevention strategies for patients, particularly in pediatric populations where such conditions can have severe consequences.