The pediatric nurse is caring for a 2-year-old with a respiratory rate of 42 breaths per minute and a FLACC score 8. Which acid-base imbalance does the pediatric team expect to find with sustained tachypnea?

Respiratory acidosis

Metabolic alkalosis

Metabolic acidosis

Respiratory alkalosis

Answer and Explanation

The Correct Answer is D

A. Respiratory acidosis results from hypoventilation, where CO₂ is retained, leading to increased carbonic acid and decreased blood pH. This is the opposite of what is expected with tachypnea.
B. Metabolic alkalosis is typically caused by loss of gastric acid (e.g., vomiting) or excessive bicarbonate intake, not by altered respiratory rates.
C. Metabolic acidosis occurs in conditions such as diarrhea, renal failure, or diabetic ketoacidosis—not directly from changes in respiratory rate.
D. Sustained tachypnea (rapid breathing), especially in a child, leads to excessive exhalation of CO₂, reducing carbonic acid levels and raising blood pH, resulting in respiratory alkalosis.

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Correct Answer is B

Explanation

A. Kawasaki disease typically presents with fever, conjunctivitis, rash, swollen hands/feet, and lymphadenopathy, not following strep throat or with joint pain as a primary feature.
B. Rheumatic heart disease is a complication of rheumatic fever, which can follow an untreated or inadequately treated streptococcal throat infection. The child’s symptoms—fever, shortness of breath (carditis), abdominal pain, and painful swollen joint (arthritis)—are classic signs of rheumatic fever, which can lead to long-term cardiac damage.
C. Coarctation of the aorta is a congenital condition involving narrowing of the aorta and typically presents with differential blood pressure between extremities, not joint swelling or post-streptococcal symptoms.
D. Dextro-transposition of the great arteries is a cyanotic congenital heart defect that presents in newborns, not older children with post-infectious symptoms.

A. Apply direct pressure 1 inch above the puncture site B. Notify the Cardiac Cath Lab that the child will be returning C. Place a call to the Interventional Radiologist D. Apply a bulky pressure dressing over the present dressing

Correct Answer is A

Explanation

A. Bright red blood indicates active arterial bleeding, most likely from the femoral artery used during the cardiac catheterization. The first priority is to stop the bleeding. Direct pressure should be applied just above the puncture site to help control the bleeding and prevent further blood loss.
B. While notifying the Cath Lab may be necessary later, intervention to stop the bleeding must come first to ensure patient safety.
C. Contacting the Interventional Radiologist may eventually be required, but it is not the first action. Immediate pressure to control bleeding is more urgent.
D. Applying a bulky dressing alone without direct pressure is inadequate in managing arterial bleeding and may delay life-saving intervention.

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The pediatric nurse is caring for a 2-year-old with a respiratory rate of 42 breaths per minute and a FLACC score 8. Which acid-base imbalance does the pediatric team expect to find with sustained tachypnea?

Nursing Test Bank

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Correct Answer is A

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