Which of the following is a sign of severe dehydration in an infant?

Correct Answer: A

Rationale: In pediatric nursing, identifying signs of dehydration in infants is crucial for timely intervention and appropriate care. The correct answer is A) sunken fontanel. A sunken fontanel in an infant is a significant indicator of severe dehydration. The fontanel, the soft spot on an infant's head, can appear sunken when there is a lack of fluid in the body due to dehydration. This occurs because the brain tissue loses fluid, causing it to retract slightly. Moist skin (option B) is not a sign of severe dehydration but rather a sign of good skin turgor, which is a positive indicator of hydration. Normal urine output (option C) may be misleading as infants with severe dehydration may actually have decreased urine output due to decreased kidney perfusion. Weight gain (option D) is not indicative of dehydration; in fact, weight loss is more commonly associated with dehydration. Educationally, understanding these signs of dehydration in infants is essential for pediatric nurses to provide safe and effective care. By recognizing the significance of a sunken fontanel as a sign of severe dehydration, nurses can promptly intervene with appropriate fluid replacement therapy to prevent complications and promote optimal health outcomes for infants.

Correct Answer: A

Rationale: In this scenario, the most likely diagnosis for a 12-year-old with spina bifida experiencing respiratory distress during anesthesia induction for an orthopedic procedure is latex anaphylaxis (Option A). Rationale for Option A: Latex allergy is common in patients with spina bifida due to repeated exposure to latex in medical settings. Anaphylaxis can manifest as respiratory distress, which fits the patient's symptoms during anesthesia induction. Prompt recognition and treatment of latex anaphylaxis are crucial in preventing life-threatening complications. Rationale for Incorrect Options: - Option B (urosepsis): Unlikely as there are no symptoms suggestive of a urinary tract infection or sepsis in the scenario. - Option C (reactive airway disease): Less likely as the sudden onset of respiratory distress during anesthesia is not typically seen in reactive airway disease. - Option D (status epilepticus): Not relevant to the presentation of respiratory distress during anesthesia induction in this case. Educational Context: Understanding common complications and comorbidities in patients with spina bifida, such as latex allergy, is essential for pediatric nurses. Recognizing the signs and symptoms of anaphylaxis and being prepared to manage it promptly is crucial in providing safe care to pediatric patients with underlying conditions like spina bifida. This case highlights the importance of thorough patient assessment, including awareness of potential allergies, in the perioperative setting.

Correct Answer: D

Rationale: The correct answer is D) disrupted attachment and routines around eating and sleeping. When a 2-year-old child is exposed to intimate partner violence (IPV) between their parents, it can have profound effects on their emotional and psychological well-being. Disrupted attachment patterns can occur as the child may struggle to form secure attachments with their caregivers due to the trauma they are experiencing at home. This can lead to difficulties in regulating emotions and forming healthy relationships in the future. Additionally, the instability and stress caused by IPV can disrupt the child's routines around eating and sleeping, impacting their overall development and well-being. Option A) conduct disorder is less likely in this scenario as conduct disorder typically presents with persistent patterns of behavior that violate the basic rights of others or major age-appropriate societal norms. While exposure to IPV can contribute to behavioral issues, conduct disorder is not the most likely problem in this case. Option B) low self-esteem may also be a consequence of exposure to IPV, but disrupted attachment and routines around eating and sleeping are more immediate concerns that directly impact the child's daily functioning and development. Option C) regression, which refers to reverting to earlier developmental stages in response to stress, may occur in some children exposed to IPV, but it is not as directly linked to the long-term impact on attachment and routines as disrupted attachment and routines around eating and sleeping. Educationally, understanding the impact of IPV on children is crucial for healthcare professionals working with pediatric populations. By recognizing the potential effects of trauma on attachment, routines, and overall well-being, nurses can provide appropriate support, interventions, and referrals to help mitigate the negative consequences of exposure to IPV in young children.

Correct Answer: D

Rationale: In managing Systemic Lupus Erythematosus (SLE) in pediatric patients, the primary treatment goal is to achieve comprehensive care that addresses various aspects of the condition. The correct answer, option D - All of the above, is the most appropriate because a holistic approach is necessary in managing SLE in children. Reducing symptoms is crucial to improve the child's well-being and prevent long-term complications. Preventing flares helps in maintaining disease control and reducing the impact of SLE on the child's daily life and overall health. Improving the quality of life is essential to ensure that the child can lead a fulfilling and functional life despite having SLE. Option A, reducing symptoms, is a part of the treatment goal but focusing solely on symptom management may not address the underlying disease process adequately. Option B, preventing flares, is crucial in maintaining disease stability but does not encompass the broader goal of improving the child's overall quality of life. Option C, improving quality of life, is an important aspect of care but may not be sufficient if symptoms are not adequately controlled or flares are not prevented. In an educational context, understanding the comprehensive approach to managing pediatric SLE is essential for pediatric nurses. By prioritizing all aspects of care - symptom reduction, flare prevention, and quality of life improvement - nurses can provide effective, patient-centered care that addresses the unique needs of children with SLE. This question highlights the importance of a holistic approach in pediatric nursing and emphasizes the multifaceted nature of managing chronic conditions like SLE in children.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding drug contraindications is crucial for safe and effective patient care. In this scenario, the correct answer is B) Aspirin. Aspirin is contraindicated in patients with gout because it can interfere with uric acid excretion, exacerbating gout symptoms and potentially leading to acute attacks. Allopurinol (option A) is actually used to treat gout by reducing uric acid levels in the blood. Colchicine (option C) is also a medication used to treat acute gout attacks. Prednisone (option D) is a corticosteroid that can be used to reduce inflammation during gout attacks. Educationally, this question highlights the importance of medication knowledge, contraindications, and the impact of drugs on specific conditions like gout. Understanding these principles is essential for pediatric nurses to provide safe and effective care to pediatric patients with various health conditions. It also emphasizes the need for critical thinking and clinical reasoning skills when making medication-related decisions in pediatric nursing practice.