Med Surg Peds Cardiac Questions

Nurse is caring for 18-month-old Aniya who has been adopted from orphanage in Haiti. Aniya has been diagnosed with Tetralogy of Fallot and will be undergoing corrective surgery. The nurse observes Aniya squatting while playing in her room. How should the nurse respond? a. Immediately administer oxygen and prepare to administer morphine to decrease infundibular spasm b. Place Aniya in her crib in side lying position while obtaining vital signs and oxygen saturation c. Immediate call for extra support d. Continue to watch and assess Aniya without changing her position

Continue to watch and assess Aniya without changing her position

5-year-old child named Amy who has Tertrology of Fallot is having cardiac surgery to repair her defects. She has developed polycythemia. What would your best action because of the development of this condition: a. Allow rest period b. Keep her well hydrated c. Keep her in semi-fowler position d. Perform passive range of motion

b. Keep her well hydrated Too much production of RBCs, want to keep her hydrated to blood doesn't get too thick

8-year-old Michael has rheumatic fever. You would expect to see which as part of his health history: a. Otitis media b. Sore throat c. Measles d. Varicella zoster

b. Sore throat

5-year-old child Amy who has been diagnosed with Tetrology of Fallot and is being admitted for cardiac surgery. During the course of your care for Amy you correctly identify the abnormal changes in heart structure in Tetrology of Fallot are:

Pulmonary artery stenosis R ventricular hypertrophy Ventricular septal defect (VSD) Dextraposition of the aorta

Child with Tetralogy of Fallot experiences which of the following types of shunting of the blood? a. Left to right b. Right to left c. Upper to lower d. Lower to upper

Right to left Increased pressure in R ventricle, causes blood to shunt over into L ventricle

Which of the following instructions would the nurse include in a teaching plan that focuses on initial prevention of rheumatic fever? a. Using corticosteroid to reduce inflammation b. Treating strep throat infection with antibiotic c. Providing antibiotic before dental work d. Giving penicillin to clients with rheumatic fever

b. Treating strep throat infection with antibiotic

8-year-old Michael has rheumatic fever. AS the nurse caring for Michael you know that which of the following symptoms of the disease leaves permanent sequelae? a. Carditis b. Polyarthritis c. Gingivitis d. Anemia

a. Carditis Causes permanent heart damage

A 10-month-old infant with tetralogy of fallot experiences a cyanotic episode or "blue spell." To improve oxygenation during such an episode, the nurse should place the infant in which position? a. Knee-to-chest b. Fowlers c. Trendelenburgs d. Prone

a. Knee-to-chest

The nurse in working in the pediatric clinic when Stuart a 3 year old with congenital heart anomalies presents. He is diagnosed with Subacute Bacterial Endocarditis (SBE). While assessing Stuart and obtaining his history, the nurse would expect to find which of the following? a. Weight loss b. Ruddy complexion c. Edema to extremities d. Restlessness and inability to sleep

a. Weight loss

The nurse is caring for 3-week-old Autumn diagnosed with ASD. Which of the following should be included in Autumns plan of care? a. Monitor I and O, weigh all diapers and weigh Autumn weakly b. Cluster all care so that oxygen demands are decreased c. Provide high calorie formula and allow autumn to feed slowly over an hour d. Allow Autumn to cry to encourage expansion and clearly lung fields

b. Cluster all care so that oxygen demands are decreased note: Never feed for more than 20-25 minutes, because at that point baby begins to use the calories they've taken in just to eat

A child, age 4, is admitted with tentative diagnosis of congenital heart disease. When assessment reveals a bounding radial pulse coupled with a weak femoral pulse, the nurse suspects that the child has: a. Patent ductus arteriosus b. Coarctation of the aorta c. Ventricular septal defect d. Truncus arteriosus

b. Coarctation of the aorta You have a difference between upper and lower extremities

A child is suspected of rheumatic fever is admitted to pediatric unit. When obtaining the child's history, the nurse considers which information to be most important? a. Fever that started 3 days ago b. Lack on interest in food c. A recent episode of pharyngitis d. Vomiting for 2 days

c. A recent episode of pharyngitis Probably was strep throat, rheumatic fever occurs after B hemolytic strep (usually untreated or don't finish treatment), Affects heart valves

The nurse if reviewing the anatomy and physiology of the heart. All of the following statements are true except: a. Prior to birth pressure is highest on the R side of the heart b. The area of highest pressure in heart of a healthy child is L ventricle c. A right to left shunt creates increased pulmonary blood flow d. Relaxation of heart is called diastole

c. A right to left shunt creates increased pulmonary blood flow

The nurse is evaluating Taylor, 10 year old with history of strep infection. Taylor has been diagnosed with rheumatic fever and the nurse needs to provide instructions to the parents. Which of the following would not be included in Taylors care? a. Explain that Taylor will be taking penicillin for the next 10 years b. Encourage Taylor to use spoon for meals while avoiding use of knives and forks c. Encourage activity such as walking and weight lifting d. Encourage Taylor to use anti-inflammatory medications for discomfort

c. Encourage activity such as walking and weight lifting notes: Long term penicillin decreases additional damage, Use spoons because chorea can occur and injury can happen with knives and forks

The nurse is caring for 3-year-old Noah with Kawasaki's disease. While assessing Noah and reviewing his results, the nurse would expect to find which of the following: a. Swelling of the conjunctiva with purulent drainage b. A very distinctive rash to extremities c. Inflammation of mouth, lips and tongue d. Lab results showing a positive ASO titer

c. Inflammation of mouth, lips and tongue Strawberry tongue, Rash varies from child to child

Amy has been diagnosed with Tetrology of Fallot and is being admitted for cardiac surgery. While playing in play room Amy stoops and squats down to the floor. The nurse should: a. Give oxygen b. Pick her up immediately and put her Fowlers position in bed c. Support child in position she assumes and observe d. Call the doctor

c. Support child in position she assumes and observe

The nurse is caring for Sam, a 2 year old with unrepaired VSD. When reviewing Sams admission history, the nurse notes that his oxygen saturations were low and he was found to be mottled with cyanosis of the mouth and extremities. These findings can be attributed to which of the following? a. A VSD causes L to R shunt which commonly leads to cyanosis b. Mottling and cyanosis are often seen in a hypothermic child c. The R side of the heart has begun to fail causing R to L shunt i. VSD causes L to R shunt, but doesn't lead to cyanosis unless right side of the heart fails d. The L side of the heart has begun to fail causing a L to R shunt

c. The R side of the heart has begun to fail causing R to L shunt VSD causes L to R shunt, but doesn't lead to cyanosis unless right side of the heart fails

The nurse is reviewing information regarding Kawasaki's disease. Which of the following is correct? a. Without treatment 50% of all children diagnosed with Kawasaki's disease will have permanent cardiac sequelae b. It is second only to Rheumatic Fever as the leading cause of acquired pediatric heart disease c. It is generally affect children over 10 years old d. It is treated with salicylate (aspirin) therapy

d. It is treated with salicylate (aspirin) therapy One of only situations where we use aspirin in children, Have a reddish rash

Nurse is caring for a child at risk for congestive heart failure secondary to a congenital heart defect that increases pulmonary blood flow except: a. Patent ductus arterious (PDA) b. Atrial septal defect (ASD) c. Ventricular septal defect (VSD) d. Pulmonary stenosis

d. Pulmonary stenosis Causes decreased pulmonary blood flow

The nurse is caring for Ben, a 4 year old with an unrepaired VSD. The nurse would expect to find all of the following in Bens' history except: a. Tachypnea with congested cough b. Tachycardia c. Height for age at 5th percentile d. Small liver that is difficult to assess

d. Small liver that is difficult to assess Liver would likely be enlarged due to increased pressure on R side of heart

Children with congenital heart conditions are extremely susceptible to: a. GI disorders b. Skin infections c. Allergic conditions d. Upper respiratory infection

d. Upper respiratory infection