Exam Flashcards

In response to hyperthermia, a term neonate may have vasodilation and sweating, which may lead to:

Answer: hypotension and dehydration

In response to hyperthermia (overheating), a neonate's body attempts to cool down through mechanisms like vasodilation (widening of blood vessels) and sweating. Excessive vasodilation can lead to a drop in blood pressure (hypotension), while increased sweating results in significant fluid loss, leading to dehydration. Neonates are particularly vulnerable to these effects due to their immature thermoregulatory systems and high surface area-to-volume ratio.

Twelve hours following the commencement of the symptoms, a 4-year-old sickle cell patient with a right-sided stroke and left hemiplegia is taken to the hospital. What medical procedure is recommended to lower the chance of having another stroke?

Answer: Exchange transfusion

For a child with sickle cell disease experiencing an acute stroke, an exchange transfusion is the recommended medical procedure to reduce the risk of another stroke. This procedure rapidly reduces the percentage of sickled red blood cells and replaces them with healthy red blood cells, improving oxygen delivery and decreasing blood viscosity. This helps prevent further vaso-occlusion and subsequent neurological damage.

Despite eating healthily and gaining weight normally, a 6-month-mother old's is concerned since her child frequently and occasionally violently vomits after meals. Gastroesophageal reflux disease (GERD) is therefore suspected. What type of main treatment is anticipated by the nurse?

Answer: Positioning and feeding modifications

For a 6-month-old infant with suspected Gastroesophageal Reflux Disease (GERD) who is otherwise healthy and gaining weight, the initial and most common treatment involves conservative measures. These include positioning modifications, such as keeping the infant upright after feeds, and feeding modifications, like smaller, more frequent feeds or thickening formula. Pharmacological interventions are typically reserved for more severe cases or when conservative measures prove insufficient.

When a newborn is treated for hypoglycemia with a glucose bolus, a continuous infusion of:

Answer: glucose

When a newborn is treated for hypoglycemia (low blood sugar) with an initial glucose bolus, a continuous infusion of glucose is necessary to maintain stable blood sugar levels. The bolus provides an immediate, rapid increase in blood glucose, but a continuous infusion prevents subsequent drops. This ensures the newborn's metabolic needs are met and helps prevent further neurological complications associated with prolonged hypoglycemia.

Which approach is the MOST efficient for addressing the "emotional contagion hypothesis," which postulates that anxious parents might make their children more anxious during invasive procedures?

Answer: Prepare the parents in advance

The 'emotional contagion hypothesis' suggests that parental anxiety can be transferred to their children, increasing the child's distress during medical procedures. The most effective approach to mitigate this is to prepare the parents in advance. Providing clear, honest information about the procedure, what to expect, and how they can support their child empowers parents, reduces their anxiety, and enables them to be a calming and supportive presence for their child.

Children's osteomyelitis most frequently develops because of:

Answer: hematogenous seeding

Osteomyelitis, an infection of the bone, most frequently develops in children through hematogenous seeding. This means the infection originates from bacteria circulating in the bloodstream, often from a distant site like a skin infection or pharyngitis. These bacteria then settle and proliferate in the bone, particularly in the highly vascular metaphysis of long bones, leading to the infection.

Having hepatomegaly, an enlarged abdomen, and stool that is the color of clay, a newborn parent four weeks after birth. Direct hyperbilirubinemia is indicated by test results. The following is the most likely reason:

Answer: Extrahepatic biliary atresia (EBA)

The symptoms described—hepatomegaly, enlarged abdomen, clay-colored stools, and direct hyperbilirubinemia in a 4-week-old newborn—are classic indicators of extrahepatic biliary atresia (EBA). EBA is a condition where the bile ducts outside the liver are blocked or absent, preventing bile from flowing into the intestine. This leads to jaundice, liver damage, and the characteristic pale or clay-colored stools due to the absence of bile pigments.