Which nursing action is especially important for an SGA newborn?

Correct Answer: D

Rationale: In the context of caring for a small for gestational age (SGA) newborn experiencing respiratory distress, the most crucial nursing action is to prevent hypoglycemia with early and frequent feedings (option D). This is because SGA infants are at a higher risk for hypoglycemia due to their decreased glycogen stores and limited ability to regulate blood sugar levels. Providing timely and regular feedings helps maintain adequate glucose levels, supporting the baby's metabolic needs and overall well-being. Option A, promoting bonding, while important for overall infant development, is not the priority in the immediate care of an SGA newborn in respiratory distress. Option B, observing for and preventing dehydration, is also significant but addressing hypoglycemia takes precedence due to its potential for serious consequences in SGA infants. Option C, observing for respiratory distress syndrome, is relevant but not specific to the needs of an SGA newborn who is already experiencing respiratory distress. Educationally, understanding the unique needs and vulnerabilities of SGA newborns is essential for nurses providing care in neonatal settings. Prioritizing interventions based on the individualized needs of each infant is crucial for optimizing outcomes and ensuring safe, effective care delivery. By recognizing the significance of preventing hypoglycemia in SGA newborns with respiratory distress, nurses can tailor their interventions to address the specific challenges these infants may face.

Correct Answer: B

Rationale: In pediatric respiratory distress, understanding the pathogens causing pneumonia is crucial for appropriate nursing interventions. The correct answer is B) Mycoplasma pneumoniae. Mycoplasma pneumoniae is a common cause of atypical pneumonia in children aged 5 years and older. It presents with milder symptoms compared to bacterial pneumonia. Option A) Streptococcus pneumoniae is a common cause of bacterial pneumonia in children, particularly in younger age groups. However, it is not the most frequent pathogen in children aged 5 years and older. Option C) Group A streptococci are more commonly associated with strep throat and skin infections rather than pneumonia in children. Option D) H. influenzae (type b, nontypable) is more commonly associated with respiratory tract infections such as epiglottitis and meningitis in children, rather than being a leading cause of pneumonia in children aged 5 years and older. Educationally, understanding the age-specific pathogens causing pneumonia helps nurses tailor their care plans effectively. By recognizing Mycoplasma pneumoniae as a frequent pathogen in older children, nurses can anticipate atypical presentations and provide appropriate treatment and monitoring, thereby improving patient outcomes.

Correct Answer: C

Rationale: In the context of pediatric respiratory distress nursing interventions, understanding cystic fibrosis is crucial. The correct answer, C) sexual function is generally impaired, is accurate because cystic fibrosis primarily affects the lungs and digestive system, leading to issues like malnutrition and delayed puberty, which can impact sexual development. Option A, delayed sexual development, is a common manifestation of cystic fibrosis due to malnutrition and hormonal imbalances. Option B, more than 95% of males are azoospermic, is true as cystic fibrosis can obstruct the vas deferens, leading to infertility. Option D, high incidence of inguinal hernia, is also a common complication due to increased intra-abdominal pressure from chronic coughing. Educationally, nurses must recognize these manifestations to provide comprehensive care for pediatric patients with cystic fibrosis. Understanding the systemic effects of the disease helps in early intervention and holistic management, including nutritional support, respiratory therapies, and psychosocial care. By knowing the unique challenges faced by these patients, nurses can tailor interventions to improve outcomes and quality of life.

Correct Answer: C

Rationale: In pediatric respiratory distress cases, understanding the etiology of pleural effusion is crucial for effective nursing interventions. The MOST common cause of pleural effusion in children is bacterial pneumonia (Option C). This is due to the inflammatory response triggered by bacterial infection in the lungs, leading to an accumulation of fluid in the pleural space. Option A, tuberculosis, though a common cause of pleural effusion in adults, is less frequent in children. Option B, heart failure, typically presents with pulmonary edema rather than pleural effusion in children. Option D, rheumatoid arthritis, is an autoimmune condition that usually does not directly cause pleural effusion in children. Educationally, understanding the predominant causes of pleural effusion in children informs nurses on the urgency and appropriate management strategies required in cases of bacterial pneumonia. Nurses need to be adept at recognizing the signs and symptoms of respiratory distress in pediatric patients to provide timely and effective care, including monitoring, administering medications, and supporting respiratory function to prevent complications associated with pleural effusion.

Correct Answer: B

Rationale: The correct answer is B) spinal muscular atrophy. In neuromuscular disorders, such as spinal muscular atrophy, respiratory muscle weakness can lead to acute respiratory insufficiency. This is due to the progressive degeneration of motor neurons, affecting respiratory muscles and leading to respiratory distress. Option A) Duchenne muscular dystrophy primarily affects skeletal muscles, leading to muscle weakness and wasting, but it typically does not cause acute respiratory insufficiency as prominently as spinal muscular atrophy. Option C) Congenital myotonic dystrophy is characterized by muscle weakness and myotonia, but it is not typically associated with acute respiratory insufficiency as a prominent clinical manifestation. Option D) Myasthenia gravis is an autoimmune disorder affecting neuromuscular junctions, leading to muscle weakness that worsens with activity but does not usually cause acute respiratory insufficiency as prominently as spinal muscular atrophy. Educationally, understanding the specific respiratory manifestations of different neuromuscular disorders is crucial for nurses caring for pediatric patients with these conditions. Recognizing the signs of respiratory distress early on can help in implementing timely interventions to prevent respiratory failure and improve patient outcomes.