Pediatric Success Chapter 6- Cardiovascular Disorders

29) The following are examples of acquired heart disease. *SATA* 1. Infective endocarditis 2. Hypo plastic left heart syndrome 3. Rheumatic fever 4. Cardiomyopathy 5. Kawasaki disease 6. Transposition of the great vessels

1. Infective endocarditis 3. Rheumatic fever 4. Cardiomyopathy 5. Kawasaki disease

27) While looking through the chart of an infant with congenital heart defect (CHD) of decreased pulmonary bloodflow, the nurse would expect which laboratory finding? 1. Decreased platelet count. 2. Polycythemia. 3. Decreased ferritin level. 4. Shift to the left.

2. Polycythemia.

4) A 10-year-old child is recovering from a severe sore throat. The parent states that the child complains of chest pain. The nurse observes that the child has swollen joint, nodules on the fingers, and a rash on the chest. The likely cause is _________________________.

Rheumatic Fever (RF).

28) The nurse is caring for a 9-month-old who was born with congenital heart defect (CHD). Assessment reveals a HR of 160, capillary refill of 4 seconds, bilateral crackles, and sweat on the scalp. These are signs of _______________________.

Congestive Heart Failure (CHF).

30) A child diagnosed with congestive heart failure (CHF) is receiving maintenance doses of digoxin and furosemide. She is rubbing her eyes when she is looking at the lights in the room, and her HR is 70 bpm. The nurse expects which laboratory finding? 1. Hypokalemia 2. Hypomagnesemia 3. Hypocalcemia 4. Hypophosphatemia

1. Hypokalemia

20) A 6-month-old who has episodes of cyanosis after crying could have the congenital heart defect (CHD) of decrease pulmonary blood flow called _________________.

Tetralogy of Fallot (TOF).

15) A child who has reddened eyes with no discharge; red, swollen, and peeling palms and soles of the feet; dry, cracked lips; and a "strawberry tongue" most likely has ___________________.

Kawasaki Disease (KD).

2) A newborn is diagnosed with a congenital heart defect (CHD). The test results reveal that the lumen of the duct between the aorta & pulmonary artery remains open. This defect is knowns as ________________.

Patent Ductus Arteriosus (PDA).

44) Treatment for congestive heart failure (CHF) in an infant began 3 days ago and has included digoxin and furosemide. The child no longer has retractions, lungs are clear, and HR is 60 bpm while the child sleeps. The nurse is confident that the child has disuresed successfully and had good renal perfusion when the nurse notes the child's urine output is: 1. 0.5 cc/kg/hr. 2. 1 cc/kg/hr. 3. 30 cc/hr. 4. 1 oz/hr.

2. 1 cc/kg/hr.

55) Aspirin has been ordered for the child with rheumatic fever (RF) in order to: 1. Keep the patient ductus arterioles (PDA) open. 2. Reduce joint inflammation. 3. Decrease swelling strawberry tongue. 4. Treat ventricular hypertrophy of endocarditis.

2. Reduce joint inflammation.

40) The nurse is caring for an an 8-year-old girl whose parents indicate she has developed spastic movements of her extremities and trunk, facial grimace, and speech disturbances. They state it seems worse when she is anxious and does not occur while sleeping. The nurse questions the parents about which recent illness? 1. Kawasaki disease (KD). 2. Strep throat. 3. Malignant hypertension. 4. Atrial fibrillation.

2. Strep throat.

10) Indomethacin may be given to close which congenital heart defect (CHD) in newborns? _____________________

Patent Ductus Arteriosus (PDA)

19) Hypoxic spells in the infant with congenital heart defect (CHD) can cause which of the following? *SATA* 1. Polycythemia 2. Blood clots 3. Cerebrovascular accident 4. Developmental delay 5. Viral pericarditis 6. Brain damage 7. Alkalosis

1. Polycythemia 2. Blood clots 3. Cerebrovascular accident 4. Developmental delay 6. Brain damage

9) Which interventions decrease cardiac demands in an infant with congestive heart failure (CHF)? *SATA* 1. Allow parents to hold and rock their child. 2. Feed only when the infant is crying 3. Keep the child uncovered to promote low body temperature. 4. Make frequent position changes 5. Feed the child when sucking the fists 6. Change bed linens only when necessary 7. Organize nursing activities

1. Allow parents to hold and rock their child. 4. Make frequent position changes 5. Feed the child when sucking the fists 6. Change bed linens only when necessary 7. Organize nursing activities

39) Exposure to which illness should be a cause to discontinue therapy and substitute dipyridamole (Persantine) in a child receiving aspirin therapy for Kawasaki disease (KD)? 1. Chickenpox or influenza. 2. E. Coli or staphylococcus. 3. Mumps or streptococcus A. 4. Streptococcus A or staphylococcus.

1. Chickenpox or influenza.

36) A child born with Down syndrome should be evaluated for which associated cardiac manifestation? 1. Congenital heart defect. 2. Systemic hypertension. 3. Hyperlipidemia. 4. Cardiomyopathy.

1. Congenital heart defect.

14) Which are the most serious complications for a child with Kawasaki disease (KD)? *SATA* 1. Coronary thrombosis 2. Coronary stenosis 3. Coronary artery aneurysm 4. Hypocoagulability 5. Decreased sedimentation rate 6. Hypoplastic left heart syndrome.

1. Coronary thrombosis 2. Coronary stenosis 3. Coronary artery aneurysm

34) Which statement by the mother of a child with rheumatic fever (RF) shows she has a good understanding of the care of her child? 1. "I will apply heat to his swollen joints to promote circulation." 2. "I will have him do gentle stretching exercises to prevent contractures. 3. "I will give him the aspirin that is ordered for pain and inflammation." 4. "I will apply cold packs to his swollen joints to reduce pain."

3. "I will give him the aspirin that is ordered for pain and inflammation."

60) Family teaching has been effective when the parent of a toddler diagnosed with Kawasaki disease (KD) states: 1. "The arthritis in her knees is permanent. She will need knee replacements." 2. "I will giver her diphenhydramine (Benadryl) for her peeling palms and soles of her feet." 3. "I know she will be irritable for 2 months after her symptoms started. " 4. "I will continue with high doses of Tylenol for her inflammation."

3. "I know she will be irritable for 2 months after her symptoms started. "

53) Which patient could require feeding by gavage? 1. Infant with congestive heart failure (CHF). 2. Toddler with repair of transposition of the great vessels. 3. Toddler with Kawasaki disease (KD) in the acute phase. 4. School-age child with rheumatic fever (RF) and chorea.

1. Infant with congestive heart failure (CHF).

54) Which physiological changes occur as a result of hypoxemia in congestive heart failure (CHF)? 1. Polycythemia and clubbing. 2. Anemia and barrel chest. 3. Increased white blood cells and low platelets. 4. Elevated erythrocyte sedimentation rate and peripheral edema.

1. Polycythemia and clubbing.

32) In which congenital heart defect (CHD) would the nurse need to take upper and lower extremity BPs? 1. Transposition of the great vessels. 2. Aortic stenosis (AS). 3. Coarctation of the aorta (COA). 4. Tetralogy of Fallot (TOF).

3. Coarctation of the aorta (COA).

17) Congenital hear defects (CHDs) are classified by which of the following? *SATA* 1. Cyanotic defect 2. Acyanotic defect 3. Defects with increased pulmonary blood flow 4. Defects with decreased pulmonary blood flow 5. Mixed defects 6. Obstructive defects 7. Pansystolic murmurs

3. Defects with increased pulmonary blood flow 4. Defects with decreased pulmonary blood flow 5. Mixed defects 6. Obstructive defects

6) Which statement by a parent of an infant with congestive heart failure (CHF) who is being sent home on digoxin indicates the need for *further* education? 1. "I will give the medication at regular 12-hour intervals." 2. "If he vomits, I will not give a make-up dose." 3. "if I miss a dose, I will not give an extra dose." 4. "I will mix the digoxin in some formula to make it taste better."

4. "I will mix the digoxin in some formula to make it taste better."

35) A child has been diagnosed with valvular disease following rheumatic fever (RF). During patient teaching the nurse discusses the child's long-term prophylactic therapy with antibiotics for dental procedures, surgery, and childbirth. The parents indicate they understand when they say: 1. "She will need to take the antibiotics until she is 18 years old." 2. "She will need to take the antibiotics for 5 years after the last attack." 3. "She will need to take the antibiotics for 10 years after the last attack." 4. "She will need to take the antibiotics for the rest of her life."

4. "She will need to take the antibiotics for the rest of her life."

52) Which statement by the mother of a child with rheumatic fever (RF) shows she has an understanding of prevention for her other children? *SATA* 1. "Whenever one of them gets a sore throat, I will give that child an antibiotic." 2. "There is no treatment. It must run its course." 3. "If their culture is positive for group A streptococcus, i will give them their antibiotic." 4. "If their culture is positive for staphylococcus A, I will give them their antibiotic.

1. "Whenever one of them gets a sore throat, I will give that child an antibiotic." 3. "If their culture is positive for group A streptococcus, i will give them their antibiotic."

42) A nursing action that promotes ideal nutrition in an infant with congestive heart failure (CHF) is: 1. Formula that is supplemented with additional calories. 2. Allowing the infant to nurse at each breast for 20 minutes. 3. Providing large feedings every 5 hours. 4. Using firm nipples with small openings to slow feedings.

1. Formula that is supplemented with additional calories.

61) Which assessment indicates that the parent of a 7-year-old is following the prescribed treatment for congestive heart failure (CHF)? 1. HR of 56 bpm. 2. Elevated RBC count. 3. 50th percentile height and weight for age. 4. Urine output of 0.5 cc/kg/hr.

3. 50th percentile height and weight for age.

31) Which plan would be appropriate in helping to control congestive heart failure (CHF) in an infant? 1. Promoting fluid restriction. 2. Feeding a low-salt formula. 3. Feeding in semi-Fowler position. 4. Encouraging breast milk.

3. Feeding in semi-Fowler position.