Which of the following best defines anion gap

Correct Answer: B

Rationale: The correct answer is B) It is the difference between unmeasured cations and unmeasured anions. Anion gap is a valuable tool in diagnosing metabolic acid-base disorders. It represents the difference between the major unmeasured cations (mainly sodium and potassium) and unmeasured anions (primarily sulfate, phosphate, and organic acids) in the blood. A normal anion gap falls within the range of 8-16 mEq/L. An elevated anion gap indicates the presence of unmeasured anions like lactate in conditions such as metabolic acidosis. Option A is incorrect because the anion gap is not about chloride depletion in metabolic alkalosis. Option C is incorrect as it refers to low bicarbonate in metabolic acidosis, not the anion gap itself. Option D is incorrect as it inaccurately defines the anion gap as the measure of sodium not bound to chloride or bicarbonate, which is not the case. Understanding the anion gap is crucial for nurses caring for pediatric patients as it helps in identifying underlying causes of metabolic acidosis and guiding appropriate treatment interventions. By interpreting the anion gap, nurses can provide timely and effective care to pediatric patients with acid-base imbalances.

Correct Answer: B

Rationale: Gaucher disease is a rare genetic disorder caused by a deficiency in the enzyme glucocerebrosidase. This enzyme is responsible for breaking down a specific type of fat molecule called glucocerebroside. When this enzyme is deficient, glucocerebroside accumulates in cells, particularly in the spleen, liver, and bone marrow, leading to the symptoms of Gaucher disease. Option A, Galactosidase, is not the correct enzyme involved in Gaucher disease. Galactosidase deficiency leads to another genetic disorder called Fabry disease, where globotriaosylceramide accumulates in cells. Option C, Galactose-1-phosphate uridyl transferase, is associated with galactosemia, a disorder where there is a buildup of galactose in the blood due to the inability to metabolize galactose properly. Option D, Sphingomyelinase, is linked to Niemann-Pick disease, a disorder characterized by the accumulation of sphingomyelin in cells due to a deficiency in this enzyme. Understanding the specific enzyme deficiencies associated with different genetic disorders is crucial in pediatric nursing. Nurses caring for children with rare genetic disorders like Gaucher disease need to have a solid foundation in the underlying pathophysiology to provide optimal care, education, and support to patients and families.

Correct Answer: A

Rationale: The correct answer is A) Respiratory acidosis, fully compensated. In this case, the ABG values indicate a low pH (acidosis) along with elevated PCO2 and HCO3 levels. These findings suggest primary respiratory acidosis due to inadequate ventilation, likely from the boy's asthma exacerbation. The fully compensated status indicates that the body's compensatory mechanisms have attempted to normalize the pH by increasing the bicarbonate levels. Option B) Respiratory alkalosis can be ruled out as the pH is low, not high. Option C) Metabolic acidosis is incorrect because the primary issue here is respiratory in nature, not metabolic. Option D) Metabolic acidosis, fully compensated is also incorrect as the primary disturbance is respiratory, not metabolic. Educationally, understanding acid-base disorders is crucial in pediatric nursing as they can indicate underlying health conditions and guide treatment. This question highlights the importance of interpreting ABG values in the context of a patient's clinical presentation, such as in a child with asthma experiencing respiratory acidosis. It also underscores the need to differentiate between respiratory and metabolic disturbances when analyzing ABGs.

Correct Answer: B

Rationale: In pediatrics, calculating the appropriate maintenance fluid for a child is crucial to prevent dehydration or fluid overload. The correct answer to the question regarding the maintenance fluid for a child weighing 20kg is option B) 1500. The most commonly used formula to calculate maintenance fluid for a child is the Holliday-Segar method, which recommends 100 ml/kg for the first 10kg, 50 ml/kg for the next 10kg, and 20 ml/kg for every kg above 20kg. For a child weighing 20kg, the calculation would be: - 100 ml/kg for the first 10kg = 10kg x 100 ml/kg = 1000 ml - 50 ml/kg for the next 10kg = 10kg x 50 ml/kg = 500 ml - 20 ml/kg for the remaining weight (20kg - 10kg = 10kg) = 10kg x 20 ml/kg = 200 ml Adding these together, 1000 ml + 500 ml + 200 ml = 1700 ml. However, in practical terms, a rounded figure is often used for ease of administration, so 1500 ml is typically prescribed for a 20kg child. Now, let's analyze why the other options are incorrect: - Option A) 1000: This amount is only considering the 100 ml/kg for the first 10kg but is not accounting for the additional 50 ml/kg for the next 10kg and 20 ml/kg for the remaining weight above 20kg. - Option C) 2000: This amount is too high and could lead to fluid overload in a 20kg child, as it exceeds the recommended calculations based on the Holliday-Segar method. - Option D) 2500: This amount is also excessive and could pose a risk of fluid overload in a 20kg child. Understanding how to calculate maintenance fluids for pediatric patients is essential for nurses and healthcare providers working with children. By mastering this skill, healthcare professionals can ensure optimal hydration levels for pediatric patients, promoting better outcomes and preventing complications related to fluid balance.

Correct Answer: A

Rationale: In dilated cardiomyopathy, the heart muscle becomes weakened and enlarged, leading to impaired contractility. This results in the heart's inability to effectively pump blood to the body. Option A, impaired contractility, is the correct answer because it directly relates to the primary characteristic of dilated cardiomyopathy. Option B, normal ventricular size, is incorrect because dilated cardiomyopathy is specifically characterized by ventricular dilation. Option C, dilated atrium, is incorrect as atrial dilation is not a primary feature of dilated cardiomyopathy. Option D, abnormal relaxation, is also incorrect as this pertains more to diastolic dysfunction rather than the systolic dysfunction seen in dilated cardiomyopathy. Understanding the features of dilated cardiomyopathy is crucial for pediatric nurses as it is a significant cause of heart failure in children. By recognizing the signs and symptoms, nurses can provide appropriate care and interventions to manage the condition effectively. It is essential for nurses to understand the pathophysiology behind dilated cardiomyopathy to deliver comprehensive care to pediatric patients with this condition.