Peds Quiz 3

- Vital organ function is maintained by intrinsic compensatory mechanism; blood flow is usually normal or increased, but generally uneven or maldistributed in the microcirculation. A. Compensated shock B. Hypoxia C. Cardiomyopathy D. Acquired cardiac disorder E. Congestive heart failure F. Polycythemia G. Clubbing H. Hypotensive shock I. Congenital heart disease

A. Compensated shock

- A reduction in tissue oxygenation that results from low oxygen saturation and PaO2 and results in impaired cellular processes. A. Compensated shock B. Hypoxia C. Cardiomyopathy D. Acquired cardiac disorder E. Congestive heart failure F. Polycythemia G. Clubbing H. Hypotensive shock I. Congenital heart disease

B. Hypoxia

Match: - Refers to abnormalities of the myocardium in which the cardiac muscles' ability to contract is impaired; relatively rare in children A. Compensated shock B. Hypoxia C. Cardiomyopathy D. Acquired cardiac disorder E. Congestive heart failure F. Polycythemia G. Clubbing H. Hypotensive shock I. Congenital heart disease

C. Cardiomyopathy

- Disease processes or abnormalities that occur after birth and can be seen in the normal heart or in the presence of congenital heart defects; resulting from factors such as infection, autoimmune responses, environmental factors, and familial tendencies. A. Compensated shock B. Hypoxia C. Cardiomyopathy D. Acquired cardiac disorder E. Congestive heart failure F. Polycythemia G. Clubbing H. Hypotensive shock I. Congenital heart disease

D. Acquired cardiac disorder

- The inability of the heart to pump an adequate amount of blood to meet the metabolic demands of the body; not a disease; in children, most common in infants; usually secondary to increases in blood volume and pressure from anomalies; result of an excessive workload imposed on normal myocardium. A. Compensated shock B. Hypoxia C. Cardiomyopathy D. Acquired cardiac disorder E. Congestive heart failure F. Polycythemia G. Clubbing H. Hypotensive shock I. Congenital heart disease

E. Congestive heart failure

- An increased number of red blood cells; increases the oxygen carrying capacity of the blood. A. Compensated shock B. Hypoxia C. Cardiomyopathy D. Acquired cardiac disorder E. Congestive heart failure F. Polycythemia G. Clubbing H. Hypotensive shock I. Congenital heart disease

F. Polycythemia

- A thickening and flattening of the tips of the fingers and toes; thought to be a result of chronic tissue hypoxemia and polycythemia. A. Compensated shock B. Hypoxia C. Cardiomyopathy D. Acquired cardiac disorder E. Congestive heart failure F. Polycythemia G. Clubbing H. Hypotensive shock I. Congenital heart disease

G. Clubbing

- Often see tachycardia which is pronounced and narrowed pulse pressure. There is poor capillary filling and the child exhibits confusion, sleepiness and decreased responsiveness. A. Compensated shock B. Hypoxia C. Cardiomyopathy D. Acquired cardiac disorder E. Congestive heart failure F. Polycythemia G. Clubbing H. Hypotensive shock I. Congenital heart disease

H. Hypotensive shock

- Includes primarily anatomic abnormalities present at birth that result in abnormal cardiac function, the consequences of which are hypoxemia and heart failure. A. Compensated shock B. Hypoxia C. Cardiomyopathy D. Acquired cardiac disorder E. Congestive heart failure F. Polycythemia G. Clubbing H. Hypotensive shock I. Congenital heart disease

I. Congenital heart disease

Which clinical manifestations would the nurse expect to see as hypovolemic shock progresses in a child and becomes decompensated shock? Choose all that apply. a. Slowed respiratory rate b. Tachycardia c. Confusion d. Cool extremities and decreased capilarry refill e. Normal skin tones f. Diminished urinary output

Tachycardia Diminished urinary output Confusion Cool extremities and decreased capilarry refill

The nurse is providing care for a 2 month old infant who has a congenital heart defect. The nurses suspects dysrythmia in the infant. What is the first action the nurse should take? a. Count the apical rate for 1 minute b. Evaluate the infant for chest deformities such as a pectus c. Assess the neck veins for distention and pulsations d. Monitor the intant's blood pressure

a. Count the apical rate for 1 minute

When caring for the child with Kawasaki disease, the nurse should know that: a. Therapeutic management includes administration of gamma globulin and aspirin. b. The child"s fever is usually responsive to antibiotics within 48 hours. c. Aspirin is contraindicated. d. The principal area of involvement is the joints.

a. Therapeutic management includes administration of gamma globulin and aspirin.

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. The most appropriate initial nursing action is to: a. Apply direct pressure above the catheterization site. b. Notify the physician immediately. c. Place the child in the Trendelenburg position. d. Apply a new bandage with more pressure

a. Apply direct pressure above the catheterization site.

A nurse is caring for a child who is suspected of having rheumatic fever. Which of the following findings should the nurse expect? (select all that apply) a. Erythema marginatum (rash) b. Continuous joint pain of the digits c. Tender, subcutaneous nodules d. Decreased erythrocyte sedimentation rate e. Elevated C-reactive protein

a. Erythema marginatum (rash) e. Elevated C-reactive protein

What action is most likely to encourage parents to talk about their feelings related to their child's illness? a. Use open-ended questions. b. Use direct questions. c. Avoid periods of silence. d. Be sympathetic.

a. Use open-ended questions.

A nurse is assessing an infant who has coarcation (narrowing) of the aorta. Which of the following findings should the nurse expect? (Select all that apply) a. Weak femoral pulses b. Severe cyanosis c. Clubbing of the fingers d. Cool skin of lower extremities e. Heart failure

a. Weak femoral pulses d. Cool skin of lower extremities e. Heart failure

A common sign of digoxin toxicity is: a. Vomiting. b. Tachycardia. c. Bradypnea. d. Seizures

a. Vomiting.

An 8-month-old infant has a hypercyanotic spell while blood is being drawn. The nurse's first action should be to: a. Assess for neurologic defects. b. Place the child in the knee-chest position. c. Prepare the family for imminent death. d. Begin cardiopulmonary resuscitation.

b. Place the child in the knee-chest position.

4 year old Tammy is hospitalized suddenly for sudden heart failure without any preparation. In planning how to best help Tammy adjust to the situation, the nurse should recognize that Tammy may likely see hospitalization as: a. An opportunity for regression b. Punishment c. Threat to child's self-image d. Loss of companionship with friends

b. Punishment

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. The nurse's reply should be based on knowing that: a. Constant parental supervision is needed to avoid overexertion. b. The child needs to understand that peers' activities are too strenuous and it is best to just observe. c. The child needs opportunities to play with peers. d. Parents can meet all the child's needs in a safer environment than with a group of other children.

c. The child needs opportunities to play with peers.

As part of the treatment for congestive heart failure, the child takes the diuretic furosemide. As part of teaching home care, the nurse encourages the family to give the child foods such as bananas, oranges, and leafy vegetables. These foods are recommended because they are high in: a. Vitamins b. Chloride c. Potassium d. Sodium

c. Potassium

A 2-year-old child comes to the emergency department with dehydration and hypovolemic shock. What best explains why an intraosseous infusion is started? a. Antibiotics must be started immediately. b. It is less painful for small children. c. Rapid venous access is not possible. d. Long-term central venous access is not possible.

c. Rapid venous access is not possible.

What is the function of the Foramen Ovale during fetal circulation? (select only one correct response). a. It closes in the last trimester of pregnancy to prepare the infant for post-birth circulation. b. It helps balance the pressures between the right side of the heart and the left side of the heart. c. It allows for oxygenated blood to flow from the left side of the heart to the right side of the heart. d. It allows for oxygenated blood to flow from the right side of the heart, to the left side of the heart

d. It allows for oxygenated blood to flow from the right side of the heart, to the left side of the heart

An important nursing consideration when chest tubes will be removed from a child is to: a. Expect bright red drainage for several hours after removal. b. Explain that a Band-Aid will be needed following the procedure. c. Explain that the procedure will be briefly painful. d. Administer analgesics before procedure.

d. Administer analgesics before procedure.