Parents have adopted a child with the diagnosis of kwashiorkor. What is most likely to be observed when assessing this child? (Select all that apply)

Edematous abdomen

Thick, oily hair

Hyperactivity

Slowed growth

White streak in hair

Answer and Explanation

Correct Answer : A,D,E

Choice A reason: Kwashiorkor, a protein-energy malnutrition, causes hypoalbuminemia, reducing oncotic pressure and leading to fluid leakage into tissues, particularly the abdomen, causing edema. This is a hallmark sign, reflecting severe protein deficiency, impairing liver albumin synthesis and causing ascites, commonly observed in children with this condition.

Choice B reason: Thick, oily hair is not characteristic of kwashiorkor, which causes thin, brittle hair due to protein deficiency impairing keratin synthesis. Hair may appear discolored or sparse, but not thick or oily. Edema and growth issues are more typical, making this an incorrect finding for kwashiorkor.

Choice C reason: Hyperactivity is not associated with kwashiorkor, which causes lethargy due to severe protein-energy deficiency, reducing metabolic capacity and energy levels. Children appear apathetic, not hyperactive. Edema and slowed growth are hallmark signs, making hyperactivity an incorrect manifestation of this malnutrition condition.

Choice D reason: Slowed growth is a hallmark of kwashiorkor, as protein deficiency impairs tissue synthesis and growth hormone function, leading to stunting. Inadequate amino acids hinder cell division and muscle development, making growth retardation a common finding in affected children, reflecting the disease’s impact on development.

Choice E reason: A white streak in hair (flag sign) occurs in kwashiorkor due to intermittent protein deficiency, disrupting melanin and keratin synthesis during hair growth. This results in alternating bands of discolored hair, a classic sign of malnutrition, reflecting periods of inadequate protein intake in affected children.

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Correct Answer is A

Explanation

Choice A reason: Isotonic dehydration involves equal loss of water and electrolytes, reducing circulating volume. This can lead to hypovolemic shock, characterized by hypotension and organ hypoperfusion, risking multi-organ failure. In children, rapid fluid loss from diarrhea or vomiting makes this the greatest life-threatening complication, requiring urgent fluid resuscitation.

Choice B reason: Metabolic acidosis may occur in dehydration from bicarbonate loss (e.g., diarrhea), but it is less immediately life-threatening than hypovolemic shock. Acidosis causes compensatory tachypnea but rarely leads to rapid death. Shock’s impact on perfusion is the primary threat, making acidosis a secondary concern in isotonic dehydration.

Choice C reason: Hypernatremia occurs in hypertonic dehydration, not isotonic, where sodium levels remain normal. Isotonic dehydration’s primary risk is volume depletion, leading to hypovolemic shock. Hypernatremia causes neurological symptoms but is not the main threat, as isotonic dehydration maintains electrolyte balance, making this incorrect.

Choice D reason: Seizures may occur in dehydration from electrolyte imbalances like hyponatremia, but isotonic dehydration maintains normal sodium levels, reducing seizure risk. Hypovolemic shock, from significant volume loss, is the greatest threat, causing cardiovascular collapse, making seizures a less immediate concern in this scenario.

A. Squirt the prescribed dose into the back of the mouth and have the infant swallow B. Give the medication mixed with a small amount of juice in a bottle C. Use a sterile applicator to swab the medication on the oral mucosa D. Pour the prescribed amount into a nipple and have the infant suck the medication

Correct Answer is C

Explanation

Choice A reason: Squirting nystatin into the back of the mouth for swallowing reduces contact with oral mucosa, where Candida albicans causes thrush. Swabbing ensures prolonged antifungal exposure to infected areas, enhancing efficacy. Swallowing is less effective, as it bypasses the site of infection, making this an incorrect administration method.

Choice B reason: Mixing nystatin with juice in a bottle dilutes the medication and reduces contact time with oral mucosa, decreasing antifungal efficacy against thrush. Juice sugars may promote yeast growth. Swabbing directly applies nystatin to affected areas, making mixing with juice an incorrect and ineffective administration method.

Choice C reason: Swabbing nystatin on the oral mucosa with a sterile applicator ensures direct contact with Candida-infected areas, maximizing antifungal action. This method treats thrush by allowing prolonged exposure to the medication, reducing yeast overgrowth in the infant’s mouth, making it the correct technique for effective administration and infection resolution.

Choice D reason: Pouring nystatin into a nipple for sucking reduces contact with oral mucosa, as much of the dose may be swallowed quickly. This decreases antifungal efficacy against thrush, which requires direct mucosal application. Swabbing is preferred, making this an incorrect method for administering nystatin in infants.

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Parents have adopted a child with the diagnosis of kwashiorkor. What is most likely to be observed when assessing this child? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

The greatest threat to life in isotonic dehydration is:

Correct Answer is A

Explanation

The nurse is instructing a mother how to administer oral nystatin suspension prescribed to treat thrush. What will the nurse include?

Correct Answer is C

Explanation

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