Which of the following is true regarding spontaneous bacterial peritonitis

Correct Answer: D

Rationale: In pediatric patients, spontaneous bacterial peritonitis (SBP) is a serious condition characterized by the infection of ascitic fluid without an evident intra-abdominal source. The correct answer is option D) Glucose less than 30 mg/dl. In SBP, the ascitic fluid glucose level is typically low due to increased consumption by bacteria. A glucose level less than 30 mg/dl is a key diagnostic criteria for SBP. Option A) Total protein more than 1 gm is incorrect because in SBP, the ascitic fluid protein level is usually low due to leakage of protein into the peritoneal cavity. Option B) Polymorphonuclear leukocytes less than 100 cells/mm3 is incorrect because in SBP, the ascitic fluid typically shows elevated levels of PMN leukocytes, usually greater than 250 cells/mm3. Option C) Culture result polymicrobial is incorrect because SBP is usually caused by a single organism, most commonly Escherichia coli or Klebsiella pneumoniae. Educationally, understanding the diagnostic criteria for SBP is crucial for nurses and healthcare providers working with pediatric patients with liver disease or ascites. Recognizing the signs and symptoms of SBP early can lead to prompt diagnosis and treatment, improving patient outcomes. It is important to remember the specific diagnostic criteria to differentiate SBP from other causes of ascitic fluid infection.

Correct Answer: A

Rationale: Functional abdominal pain is a common issue in children and adolescents, characterized by recurrent abdominal pain without an identifiable organic cause. The feature suggesting functional abdominal pain in this context is being well between pain episodes, which is option A. This is because functional abdominal pain typically presents as episodic discomfort that is not associated with other symptoms or signs of illness. Children with functional abdominal pain are usually healthy and have normal growth and development between episodes of pain. Dysphagia, option B, refers to difficulty swallowing and is not typically associated with functional abdominal pain. Nocturnal diarrhea, option C, is not a common feature of functional abdominal pain and may suggest other gastrointestinal issues. Persistent vomiting, option D, is also not a typical feature of functional abdominal pain and can indicate more serious underlying conditions. In an educational context, understanding the features of functional abdominal pain is crucial for healthcare professionals working with pediatric patients. Recognizing these features helps in differentiating functional abdominal pain from other causes of abdominal discomfort, leading to appropriate management and interventions. By knowing that being well between pain episodes is a key characteristic, healthcare providers can provide targeted care and support to children and adolescents experiencing this condition.

Correct Answer: B

Rationale: In pediatric nursing, the 'look, listen, feel' approach is used to assess breathing. This method involves observing the chest rise and fall to assess respiratory effort (look), listening for breath sounds and any abnormal sounds like wheezing or stridor (listen), and feeling for the presence of air movement and any abnormalities like crepitus (feel). The correct answer, option B (Breathing), is right because the 'look, listen, feel' approach specifically focuses on assessing the respiratory status of the pediatric patient. Breathing is a critical function that must be assessed promptly in pediatric patients as any compromise in respiratory function can lead to serious consequences. Option A (Circulation) is incorrect because the 'look, listen, feel' approach does not primarily focus on assessing circulation. Circulation assessments involve checking for pulses, capillary refill, and skin color which are not part of this particular assessment technique. Option C (Airway patency) is incorrect because while maintaining airway patency is crucial, the 'look, listen, feel' approach is not primarily used to assess airway patency. Airway assessments involve checking for obstructions, proper positioning, and the presence of secretions. Option D (Consciousness) is incorrect as well because the 'look, listen, feel' approach does not directly assess consciousness. Consciousness assessments involve evaluating the level of alertness, orientation, and response to stimuli. Educationally, understanding the importance of proper respiratory assessment techniques in pediatric patients is crucial for nurses. By mastering techniques like 'look, listen, feel,' nurses can accurately identify respiratory issues early, intervene promptly, and ensure better outcomes for their pediatric patients.

Correct Answer: B

Rationale: In pediatric nursing, recognizing early signs of shock is crucial for timely intervention. The correct answer is B) Tachypnea, which refers to rapid breathing. In the context of shock, tachypnea is an early compensatory mechanism to maintain oxygenation. As the body tries to compensate for decreased perfusion, respiratory rate increases to improve oxygen delivery. Option A) Hypotension typically occurs in the later stages of shock as a decompensatory response when compensatory mechanisms fail. It is a late sign and not an early indicator of shock in pediatric patients. Option C) Lethargy is a sign of inadequate perfusion but is also a later manifestation. Option D) Bradycardia is also a late sign of shock in pediatric patients, reflecting severe decompensation of the cardiovascular system. Educationally, understanding the progression of shock and recognizing early signs is vital for pediatric nurses. By identifying tachypnea as an early indicator, nurses can initiate prompt interventions such as fluid resuscitation and monitoring to prevent further deterioration. This knowledge enhances patient outcomes and underscores the importance of swift assessment and critical thinking in pediatric care.

Correct Answer: B

Rationale: In pediatric nursing, recognizing early signs of shock is crucial for prompt intervention. The correct answer is B) Irritability. Irritability is an early sign of shock in pediatrics because children often exhibit behavioral changes before physiological symptoms become evident. Irritability may indicate the child's increasing agitation due to decreased tissue perfusion. Option A) Cyanosis is a late sign of shock, occurring after tissue hypoxia is advanced. Option C) Lethargy is also a late sign, reflecting severe compromise of organ function. Option D) Irregular breathing can occur in shock but is not specific to its early stages. Educationally, understanding early signs of shock in children is essential for nurses to intervene promptly. Teaching pediatric nurses to recognize subtle behavioral changes like irritability can lead to early detection and timely management of shock in pediatric patients, ultimately improving outcomes.