Which is the priority nursing assessment when providing care for an infant at risk for dehydration?

Correct Answer: D

Rationale: In pediatric nursing, assessing infants at risk for dehydration requires a comprehensive approach to prioritize care effectively. The correct answer, D) Daily weight, is crucial because infants are more vulnerable to fluid imbalances due to their small size and rapid metabolic rate. Daily weight monitoring in infants can provide early indications of fluid loss or gain, helping to guide timely interventions. Option A) Urine output is important in assessing hydration status, but in infants, it can be variable and may not provide a reliable indicator of dehydration, especially in cases of insensible water loss. Urine specific gravity, option B), is also a useful indicator but may not be as practical or sensitive in infants compared to adults. While vital signs, option C), are important in assessing overall health, they may not be as specific indicators of dehydration in infants as changes can be subtle and easily missed. Daily weight monitoring is a more direct and reliable method to detect changes in fluid status in infants. In an educational context, understanding the rationale behind prioritizing daily weight assessment in dehydrated infants is crucial for pediatric nurses to provide safe and effective care. By emphasizing the significance of daily weight monitoring, nurses can proactively identify and manage dehydration in infants, ultimately improving patient outcomes and safety.

Correct Answer: C

Rationale: In the management of heart failure, the preferred diuretic due to its demonstrated significant mortality reduction in patients with heart failure is Spironolactone (Aldactone). Spironolactone is a potassium-sparing diuretic that not only helps in reducing fluid overload but also exerts additional benefits through its aldosterone antagonistic effects. By blocking aldosterone receptors, Spironolactone helps in reducing myocardial fibrosis and remodeling, leading to improved outcomes in heart failure patients. The other options listed are not preferred for significant mortality reduction in heart failure: A) Furosemide (Lasix): While Furosemide is commonly used to manage fluid overload in heart failure, it does not offer the same mortality benefits as Spironolactone. B) Hydrochlorothiazide (HydroDIURIL): Hydrochlorothiazide is a thiazide diuretic that is not typically used for the management of heart failure. It is more commonly used for hypertension and edema due to other causes. D) Mannitol (Osmitrol): Mannitol is an osmotic diuretic that is not commonly used in the management of heart failure. It is more often used for conditions such as cerebral edema or acute kidney injury. In pediatric nursing practice, understanding the rationale behind choosing specific medications for conditions like heart failure is crucial for providing safe and effective care to pediatric patients. It is essential to be aware of the pharmacological properties of diuretics and their impact on pediatric patients with heart failure to optimize treatment outcomes and minimize adverse effects.

Correct Answer: C

Rationale: In the treatment of Parkinson's disease, the goal of pharmacologic therapy is to balance cholinergic and dopaminergic activity in the brain, which is why option C is correct. Dopamine is a neurotransmitter that is deficient in Parkinson's disease, leading to motor symptoms. By aiming to balance cholinergic (acetylcholine) and dopaminergic activity, medications can help alleviate symptoms and improve motor function in patients with Parkinson's disease. Option A, to increase the amount of acetylcholine at the pre-synaptic neurons, is incorrect because Parkinson's disease is primarily characterized by a lack of dopamine, not acetylcholine. Option B, to reduce the amount of dopamine available in the substantia nigra, is also incorrect as the goal is to increase dopamine levels to compensate for the deficiency. Option D, to block dopamine receptors in pre-synaptic and post-synaptic neurons, is not aligned with the treatment approach for Parkinson's disease, which focuses on enhancing dopamine activity rather than blocking it. Educationally, understanding the goals of pharmacologic therapy in Parkinson's disease is crucial for pediatric nurses caring for patients with this condition. By grasping the rationale behind the medications used, nurses can ensure safe administration, monitor for effectiveness, and educate patients and families on the purpose and expected outcomes of treatment. This knowledge enhances the quality of care provided to pediatric patients with Parkinson's disease and contributes to better patient outcomes.

Correct Answer: C

Rationale: Following the administration of Gardasil, the HPV vaccine, routine screening with a PAP test is necessary. While Gardasil protects against certain types of HPV, it does not cover all strains that could lead to cervical cancer. Therefore, individuals who have received the vaccine should still undergo regular PAP tests to screen for cervical abnormalities caused by other HPV strains.

Correct Answer: C

Rationale: In this scenario, option C is the most appropriate statement to include in the teaching plan as it provides crucial information about the fentanyl patch's onset of action. Understanding that it may take about 24 hours for the patient to feel the full effects of the patch is essential for managing pain effectively without becoming discouraged by immediate results. Option A is incorrect as fentanyl patches are typically worn for 72 hours before being changed, not daily. Changing the patch more frequently could lead to overdose. Option B is incorrect because fentanyl, being a potent opioid, does have the potential to cause respiratory depression, especially if used improperly or in high doses. It is crucial for patients to be aware of this risk. Option D is incorrect as using a heating pad with a fentanyl patch can increase the absorption rate of the medication, leading to potential overdose and adverse effects. It is important to educate patients to avoid heat sources with fentanyl patches. Educationally, this question emphasizes the importance of accurate patient education regarding pain management medications, including dosing, onset of action, potential side effects, and proper use to ensure safe and effective pain control in pediatric oncology patients.