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. The anion gap is a calculated value used in the evaluation of metabolic acidosis. It is primarily a reflection of the balance of sodium and potassium ions in relation to chloride and bicarbonate ions. Option A is incorrect because the anion gap is not specific to chloride depletion in metabolic alkalosis. Option C is incorrect because the anion gap is not a measure of how low bicarbonate is in metabolic acidosis; rather, it reflects the presence of unmeasured anions. Option D is incorrect because the anion gap is not related to sodium specifically not being bound to chloride or bicarbonate. In the context of pediatric nursing, understanding the concept of anion gap is crucial for assessing and managing children with metabolic acidosis. By calculating the anion gap, healthcare providers can determine the underlying cause of acidosis and guide appropriate treatment. This knowledge is essential for pediatric nurses to provide safe and effective care to their young patients.

Correct Answer: B

Rationale: Gaucher disease is a genetic disorder characterized by the deficiency of the enzyme glucocerebrosidase. This enzyme is responsible for breaking down a specific type of fat molecule called glucocerebroside. When there is a deficiency in this enzyme, glucocerebroside accumulates in cells, particularly in the spleen, liver, and bone marrow, leading to the symptoms associated with Gaucher disease such as hepatosplenomegaly, anemia, thrombocytopenia, and bone abnormalities. Option A, Galactosidase, is not the correct enzyme associated with Gaucher disease. Galactosidase is deficient in Fabry disease, a different lysosomal storage disorder. Option C, Galactose-1-phosphate uridyl transferase, is deficient in Galactosemia, a disorder related to galactose metabolism, not associated with Gaucher disease. Option D, Sphingomyelinase, is deficient in Niemann-Pick disease, another lysosomal storage disorder, not Gaucher disease. Understanding the specific enzyme deficiency in Gaucher disease is crucial for nurses caring for pediatric patients. Recognizing the signs and symptoms of Gaucher disease and understanding the underlying pathophysiology is essential for early identification, appropriate management, and providing support to patients and families affected by this condition.

Correct Answer: A

Rationale: In this case, the correct answer is A) Respiratory acidosis, fully compensated. The ABG values show a pH of 7.35 (slightly acidic), elevated PCO2 of 72 (indicating respiratory acidosis), and elevated HCO3 of 30 (compensatory increase in bicarbonate levels). The child's asthma exacerbation likely led to increased CO2 retention, causing respiratory acidosis. The compensatory increase in bicarbonate (HCO3) levels indicates the kidneys are attempting to restore acid-base balance. This combination of respiratory acidosis with metabolic compensation results in fully compensated respiratory acidosis. Option B) Respiratory alkalosis, fully compensated, is incorrect as the ABG values do not support alkalosis. Option C) Metabolic acidosis, uncompensated, is incorrect because there is evidence of compensation (elevated HCO3). Option D) Metabolic acidosis, fully compensated, is incorrect as the primary disorder is respiratory (elevated PCO2). Educationally, understanding ABG interpretation is crucial in pediatric nursing to assess a child's respiratory status and guide appropriate interventions. Recognizing acid-base disorders and their compensatory mechanisms is essential for providing safe and effective care for pediatric patients with respiratory conditions like asthma.

Correct Answer: B

Rationale: In pediatric nursing, calculating maintenance fluid requirements accurately is crucial to prevent complications like dehydration or fluid overload. For a child weighing 20kg, the correct maintenance fluid calculation is 4 mL/kg/hour for the first 10kg, then 2 mL/kg/hour for the next 10kg. So for a 20kg child: - First 10kg: 10kg x 4mL/kg/hour = 40mL/hour - Next 10kg: 10kg x 2mL/kg/hour = 20mL/hour - Total: 40mL + 20mL = 60mL/hour Over a 24-hour period: - 60mL/hour x 24 hours = 1440mL Among the options provided: A) 1000: This is lower than the calculated 1440mL, which would be insufficient to meet the child's fluid needs. C) 2000: This is higher than the calculated 1440mL, which could potentially lead to fluid overload in the child. D) 2500: This is also higher than the calculated 1440mL and would exceed the child's maintenance fluid requirements, risking fluid overload. Educational Context: Understanding pediatric fluid calculations is fundamental in pediatric nursing to provide safe and effective care. Nurses must be able to accurately calculate and administer fluids to prevent complications. This question reinforces the importance of applying accurate pediatric fluid calculations based on weight, ensuring optimal patient outcomes.

Correct Answer: A

Rationale: In pediatric nursing, understanding dilated cardiomyopathy is crucial for providing effective care to children with heart conditions. Dilated cardiomyopathy is characterized by impaired contractility, which is the correct answer (A). This means the heart muscle is weakened and unable to pump blood effectively. Option B, normal ventricular size, is incorrect because dilated cardiomyopathy actually leads to enlargement of the heart chambers. Option C, dilated atrium, is incorrect because the dilation primarily affects the ventricles. Option D, abnormal relaxation, is incorrect because dilated cardiomyopathy is more associated with impaired contractility rather than relaxation abnormalities. Educationally, knowing these distinctions helps nurses accurately assess and manage pediatric patients with dilated cardiomyopathy. Recognizing the signs and symptoms of this condition can lead to prompt intervention and improved outcomes for children with heart failure. Understanding the pathophysiology behind dilated cardiomyopathy is essential for delivering safe and effective care in pediatric nursing practice.