Pedi Chapter 29

QT interval

Represents ventricular depolarization and repolarization

T wave

Represents ventricular repolarization

A chest radiography examination is ordered for a child with suspected cardiac problems. The child's parent asks the nurse, "What will the x-ray show about the heart?" The nurse's response should be based on knowledge that the radiograph provides which information?

Supplies information on heart size and pulmonary blood flow patterns

The nurse is teaching an adolescent with elevated triglycerides foods that should be decreased. What foods should the nurse include in the teaching? (Select all that apply.)

White flour White rice Sugary cereals

After returning from cardiac catheterization, the nurse monitors the child's vital signs. The heart rate should be counted for how many seconds?

60 seconds

The nurse is giving discharge instructions to the parent of a 6-year-old child who had a cardiac catheterization 4 hours ago. What statement by the parent indicates a correct understanding of the teaching?

"I should change the bandage every day for the next 2 days."

A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate?

90 beats/min

What child has a cyanotic congenital heart defect?

A 2-month-old infant with tetralogy of Fallot

What nursing consideration is important when suctioning a young child who has had heart surgery?

Administer supplemental oxygen before and after suctioning

A cardiac defect that allows blood to shunt from the (high pressure) left side of the heart to the (lower pressure) right side can result in which condition?

Heart failure

What type of drug reduces hypertension by interfering with the production of angiotensin II?

Angiotensin-converting enzyme (ACE) inhibitors

The test that provides the most reliable evidence of recent streptococcal infection is which?

Antistreptolysin O test

What cardiovascular defect results in obstruction to blood flow?

Aortic stenosis

The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is "too wet." The nurse finds the bandage and bed soaked with blood. What nursing action is most appropriate to institute initially?

Apply direct pressure above the catheterization site

What interventions should the nurse anticipate being administered to a child with supraventricular tachycardia (SVT)?

Applying ice to the face Administration of adenosine (Adenocor) Having the child perform a Valsalva maneuver

Decreasing the demands on the heart is a priority in care for the infant with heart failure (HF). In evaluating the infant's status, which finding is indicative of achieving this goal?

Appropriate weight gain for age

Selective cholesterol screening is recommended for children older than the age of 2 years with which risk factor?

BMI = 95th percentile

What drug is an angiotensin-converting enzyme (ACE) inhibitor?

Captopril (Capoten)

What term is defined as the volume of blood ejected by the heart in 1 minute?

Cardiac output

The nurse is caring for a child with Kawasaki disease in the acute phase. What clinical manifestations should the nurse expect to observe? (Select all that apply.)

Cervical lymphadenopathy Strawberry tongue Erythematous palms

What statement best identifies the cause of heart failure (HF)?

Consequence of an underlying cardiac defect

What primary nursing intervention should be implemented to prevent bacterial endocarditis?

Counsel parents of high-risk children

The nurse is preparing to give digoxin (Lanoxin) to a 9-month-old infant. The nurse checks the dose and draws up 4 ml of the drug. The most appropriate nursing action is which?

Do not give the dose; suspect a dosage error

A child is recovering from Kawasaki disease (KD). The child should be monitored for which?

Electrocardiograph (ECG) changes

The nurse is teaching parents about administering digoxin (Lanoxin). What instructions should the nurse tell the parents?

Give the medication at regular intervals

The nurse is teaching an adolescent with hypertension foods recommended on the DASH diet. What foods should the nurse include in the teaching session? (Select all that apply.)

Green beans Low-fat yogurt Whole grain bread

Mitral valve

Has 2 leaflets

Tricuspid valve

Has 3 leaflets

What medication used to treat heart failure (HF) is a diuretic?

Hydrochlorothiazide (Diuril)

Bacterial infective endocarditis (IE) should be treated with which protocol?

IV antibiotics (penicillin type) for 2 to 8 weeks

A parent of a 7-year-old girl with a repaired ventricular septal defect (VSD) calls the cardiology clinic and reports that the child is just not herself. Her appetite is decreased, she has had intermittent fevers around 38° C (100.4° F), and now her muscles and joints ache. Based on this information, how should the nurse advise the mother?

Immediately bring the child to the clinic for evaluation

What nutritional component should be altered in the infant with heart failure (HF)?

Increase in calories

What blood flow pattern occurs in a ventricular septal defect?

Increased pulmonary blood flow

A 1-year-old has been admitted for complete repair of a tetralogy of Fallot. What assessment finding should the nurse expect to be documented?

Increasing cyanosis

A 6-year-old child is scheduled for a cardiac catheterization. What consideration is most important in planning preoperative teaching?

Preoperative teaching should be adapted to his level of development so that he can understand.

What preparation should the nurse consider when educating a school-age child and the family for heart surgery?

Let the child hear the sounds of a cardiac monitor, including alarms.

The nurse is caring for a child after cardiac surgery. What interventions should the nurse implement with regard to chest tubes placed to a water-seal drainage system? (Select all that apply.)

Maintain sterility Check for tube latency Do not interrupt the water-seal drainage system

The diagnosis of hypertension depends on accurate assessment of blood pressure (BP). What is the appropriate technique to measure a child's BP?

Measure BP with the child in the sitting position on three separate occasions.

An adolescent is being placed on a beta-blocker. What should the nurse inform the adolescent with regard to this medication? (Select all that apply.)

Medication may cause fatigue Side effects may include impotence Side effects may include bradycardia

The nurse notices that a child is increasingly apprehensive and has tachycardia after heart surgery. The chest tube drainage is now 8 ml/kg/hr. What should be the nurse's initial intervention?

Notify the practitioner of these findings

The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes the risk of cerebrovascular accidents (strokes) occurring. What strategy is an important objective to decrease this risk?

Prevent dehydration

The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurse's response should be based on which knowledge?

Parents need to learn specific, important guidelines for administration of digoxin.

Seventy-two hours after cardiac surgery, a young child has a temperature of 38.4° C (101.1° F). What action should the nurse perform?

Report findings to the practitioner

P wave

Represents atrial depolarization

ST segment

Represents the time that the ventricles are in the absolute refractory period

QRS complex

Represents ventricular depolarization

A 3-month-old infant has a hypercyanotic spell. What should be the nurse's first action?

Place the child in the knee-chest position

What sign/symptom is a major clinical manifestation of rheumatic fever (RF)?

Polyarthritis

An infant has tetralogy of Fallot. In reviewing the record, what laboratory result should the nurse expect to be documented?

Polycythemia

An infant is diagnosed with transposition of the great vessels. Prostaglandin E1 is given intravenously. The parents ask how long the child will remain on the prostaglandin E1. What is the appropriate response by the nurse?

Prostaglandin E1 will be given continuously until corrective surgery is performed.

A 12-year-old child with Down syndrome is admitted to the hospital for surgical correction of a heart defect. The boy's mental age is that of a 3-year-old child. The nurse should prepare the child and family for surgery by what method?

Provide teaching to the parents, keeping the information to the child simple.

The health care provider suggests surgery be performed for ventricular septal defect to prevent what complication?

Pulmonary hypertension

What structural defects constitute tetralogy of Fallot?

Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

The physician suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent which complication?

Pulmonary vascular congestion

After returning from cardiac catheterization, the nurse determines that the pulse distal to the catheter insertion site is weaker. How should the nurse respond?

Record data on the assessment flow record

What action by the school nurse is important in the prevention of rheumatic fever (RF)?

Refer children with sore throats for throat cultures

What condition is the leading cause of death after heart transplantation?

Rejection

The nurse is caring for a child with secondary hypertension. What renal disorders are associated with secondary hypertension? (Select all that apply.)

Renal tumor Hydronephrosis Glomerulonephritis

The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min during sleep. What nursing intervention is most appropriate at this time?

Report data to the practitioner

A child with heart failure is on Lanoxin (digoxin). The laboratory value a nurse must closely monitor is which?

Serum potassium

An adolescent is being placed on an ACE inhibitor. What should the nurse inform the adolescent with regard to this medication? (Select all that apply.)

Stay well hydrated Avoid rapid position changes Side effects may include a cough

The parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. How should the nurse reply to this concern?

The child needs opportunities to play with peers

Nursing care of the child with Kawasaki disease is challenging because of which occurrence?

The child's irritability

An adolescent is being placed on a calcium channel blocker. What should the nurse inform the adolescent with regard to this medication? (Select all that apply.)

The medication may increase HR The medication may cause constipation The medication may cause peripheral edema

Ventricles

The two bottom chambers of the heart

Atria

The two chambers of the heart

When caring for the child with Kawasaki disease, what should the nurse know to provide safe and effective care?

Therapeutic management includes administration of gamma globulin and salicylates.

A 6-month-old infant presents to the clinic with failure to thrive, a history of frequent respiratory infections, and increasing exhaustion during feedings. On physical examination, a systolic murmur is detected, no central cyanosis, and chest radiography reveals cardiomegaly. An echocardiogram is done that shows left-to-right shunting. This assessment data is characteristic of what?

Ventricular septal defect

What clinical manifestation is a common sign of digoxin toxicity?

Vomiting

Heart failure (HF) is a problem after the child has had a congenital heart defect repaired. The nurse knows a sign of HF is what?

Wheezing