Which is not a common cause of serum sickness?

Correct Answer: D

Rationale: In this question, the correct answer is D) Aspirin. Serum sickness is a type III hypersensitivity reaction caused by the formation of immune complexes in response to certain medications or antigens. Aspirin is not a common cause of serum sickness compared to the other options provided. Penicillin, cephalosporins, and sulfonamides are known to be common causes of serum sickness due to their ability to induce an immune response leading to the production of immune complexes. These drugs are more frequently associated with serum sickness reactions in pediatric patients. Educationally, it is important for pediatric clinical nurse specialists to be familiar with the common causes of serum sickness in order to recognize and manage these reactions promptly in pediatric patients. Understanding the pathophysiology of serum sickness and being able to identify potential triggers can help in providing safe and effective care to children experiencing hypersensitivity reactions.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Respiratory acidosis, partially compensated. This interpretation is based on the arterial blood gas results showing a low pH (acidosis) along with an elevated PaCO2 (respiratory component) and an elevated HCO3 (metabolic compensation). Option A) Respiratory acidosis, uncompensated is incorrect because there is evidence of metabolic compensation with an elevated HCO3 level. Option C) Metabolic acidosis, partially uncompensated is incorrect as the primary issue is respiratory acidosis with metabolic compensation. Option D) Metabolic alkalosis, uncompensated is incorrect as the blood gas results clearly indicate acidosis, not alkalosis. In an educational context, understanding arterial blood gas interpretation is crucial for pediatric clinical nurse specialists to assess and manage respiratory conditions effectively. This case highlights the importance of recognizing respiratory acidosis, understanding compensatory mechanisms, and differentiating primary and compensatory disorders in pediatric patients with respiratory distress.

Correct Answer: C

Rationale: The main diagnostic sign of cardiac arrest is the absence of a central pulse, which signifies the cessation of effective heart function. In a pediatric patient, this is a critical indicator of cardiac arrest due to the immediate threat it poses to the child's life. Option A, apnea, although it can be a symptom of cardiac arrest, is not the main diagnostic sign. A child may have stopped breathing due to various reasons other than cardiac arrest. Option B, shock, is a state of circulatory collapse and inadequate tissue perfusion. While shock can be a consequence of cardiac arrest, it is not the main diagnostic sign. Option D, absence of peripheral pulse, is also a possible sign of cardiac arrest, but it is not as reliable or as easily detectable as the absence of a central pulse. Educationally, understanding the key diagnostic signs of cardiac arrest in pediatric patients is crucial for healthcare providers, especially for Pediatric Clinical Nurse Specialists. Recognizing these signs promptly is essential for initiating immediate life-saving interventions such as CPR and defibrillation. This knowledge can make a significant difference in the outcomes of pediatric patients experiencing cardiac emergencies.

Correct Answer: D

Rationale: The correct answer is D) Expelling a foreign body in the airway in the unconscious child. The Heimlich maneuver, also known as abdominal thrusts, is a first aid procedure used to help a choking person who is conscious or unconscious by expelling a foreign object blocking the airway. In the context of pediatric care, this maneuver is crucial as children are prone to putting small objects in their mouths. Option A, opening the airway in the presence of possible cervical spine injury, is incorrect because the Heimlich maneuver is not indicated for this purpose. Performing the maneuver in such cases could exacerbate the spinal injury. Option B, restoring spontaneous circulation in children with cardiac arrest, is also incorrect. The Heimlich maneuver is not intended for treating cardiac arrest but rather for clearing a blocked airway to enable breathing. Option C, chest compression in a large child to ensure adequate compression, is not the purpose of the Heimlich maneuver. Chest compressions are part of cardiopulmonary resuscitation (CPR) and are used in cases of cardiac arrest, not choking. In an educational context, it is essential for healthcare providers, especially pediatric clinical nurse specialists, to be well-versed in performing the Heimlich maneuver correctly to effectively manage choking emergencies in children. Understanding the correct indications and techniques for this maneuver can make a significant difference in saving a child's life during a choking incident.

Correct Answer: B

Rationale: In pediatric basic life support, chest compressions should be done with extended elbow, which is option B. This is the correct technique because it allows for effective transfer of force from the provider's upper body through the arms and into the chest of the child, ensuring proper compression depth and rate to maintain perfusion. Option A, extended shoulder, is incorrect because chest compressions should not be performed with the shoulders; rather, the force should come from the upper body and arms. Option C, flexed wrist, is incorrect as wrist flexion can lead to improper hand placement and ineffective compressions. Wrist stability is crucial to maintain proper alignment and force transmission. Option D, flexed elbow, is also incorrect as flexing the elbows during chest compressions can limit the ability to generate sufficient force and depth needed for effective compressions. Educationally, it is important to emphasize the correct technique for pediatric basic life support to ensure that healthcare providers are equipped with the necessary skills to respond effectively during emergencies involving pediatric patients. Proper chest compression technique can significantly impact outcomes in pediatric resuscitation scenarios, making it essential for healthcare professionals to be proficient in this skill.