cardiac

Which finding might delay a cardiac catheterization procedure on a 1-year-old? 1. 30th percentile for weight. 2. Severe diaper rash. 3. Allergy to soy. 4. Oxygen saturation of 91% on room air.

2. Severe diaper rash. 2. A child with severe diaper rash has potential for infection if the interventionist makes the standard groin approach.

A 3-month-old has been diagnosed with a ventricular septal defect (VSD). The flow of blood through the heart is _____________________.

Left to right. The pressures in the left side of the heart are greater, causing the flow of blood to be from an area of higher pressure to lower pressure, or left to right, increasing the pulmonary blood flow with the extra blood.

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

Patent ductus arteriosus or PDA. Prostaglandins allow the duct to remain open; thus, a prostaglandin inhibitor, such as Indocin or ibuprofen, can help close the duct.

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

Patent ductus arteriosus or PDA. This is a defect with increased pulmonary flow. It should close in the first few weeks of life.

For the child with hypoplastic left heart syndrome, which drug may be given to allow the patent ductus arteriosus (PDA) to remain open until surgery?

Prostaglandin E.

A young child with tetralogy of Fallot may assume a posturing position as a compensatory mechanism. The position automatically assumed by the child is the low Fowler position. the prone position. the supine position. the squatting position.

the squatting position. The squatting or knee-chest position increases the return of blood flow to the heart for oxygenation in a child with a defect that consists of decreased pulmonary blood flow.

The primary therapy for secondary hypertension in children is weight reduction. low-salt diet. increased exercise and fitness. treatment of underlying cause.

treatment of underlying cause.

What is an early sign of congestive heart failure that the nurse should recognize? Tachypnea Bradycardia Inability to sweat Increased urinary output

Tachypnea Tachypnea is one of the early signs of congestive heart failure that should be identified. Tachycardia at rest, dyspnea, retractions, and activity intolerance are other physical signs and symptoms.

What is considered a mixed cardiac defect? Pulmonic stenosis Atrial septal defect Patent ductus arteriosus Transposition of the great arteries

Transposition of the great arteries

What is an important nursing responsibility when a dysrhythmia is suspected? Order an immediate electrocardiogram. Count the radial pulse every 1 minute for five times. Count the apical pulse for 1 full minute, and compare the rate with the radial pulse rate. Have someone else take the radial pulse simultaneously with the apical pulse.

Count the apical pulse for 1 full minute, and compare the rate with the radial pulse rate.

The nurse should explain to the parents that their child is receiving furosemide (Lasix) for severe congestive heart failure because of its effects as a diuretic. a beta blocker. a form of digitalis. an ACE inhibitor.

a diuretic. Furosemide is a diuretic used to eliminate excess water and salt to prevent the accumulation of fluid associated with congestive heart failure.

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

1. Congenital heart defect (CHD)

The nurse is caring for a child with Kawasaki disease (KD). A student nurse who is on the unit asks if there are medications to treat this disease. The nurse's response to the student nurse is: 1. Immunoglobulin G and aspirin. 2. Immunoglobulin G and ACE inhibitors. 3. Immunoglobulin E and heparin. 4. Immunoglobulin E and ibuprofen.

1. Immunoglobulin G and aspirin.

Tetralogy of Fallot (TOF) involves which defects? Select all that apply. 1. Ventricular septal defect (VSD). 2. Right ventricular hypertrophy. 3. Left ventricular hypertrophy. 4. Pulmonic stenosis (PS). 5. Pulmonic atresia. 6. Overriding aorta.

1. Ventricular septal defect (VSD). 2. Right ventricular hypertrophy. 4. Pulmonic stenosis (PS). 6. Overriding aorta. Tetralogy of Fallot has four defects. Pulmonary stenosis causes decreased pulmonary flow.

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 3. The infant has a great deal of difficulty feeding with CHF, so even getting the maintenance fluids is a challenge. The infant is fed in the more upright position so fluid in the lungs can go to the base of the lungs, allowing better expansion.

A child has been seen by the school nurse for dizziness since the start of the school term. It happens when standing in line for recess and homeroom. The child now reports that she would rather sit and watch her friends play hopscotch because she cannot count out loud and jump at the same time. When the nurse asks her if her chest ever hurts, she says yes. Based on this history, the nurse suspects that she has: 1. Ventricular septal defect (VSD). 2. Aortic stenosis (AS). 3. Mitral valve prolapse. 4. Tricuspid atresia.

2. Aortic stenosis (AS). 2. AS can progress, and the child can develop exercise intolerance that can be better when resting.

The school nurse has been following a child who comes to the office frequently for vague complaints of dizziness and headache. Today, she is brought in after fainting in the cafeteria following a nosebleed. Her BP is 122/85, and her radial pulses are bounding. The nurse suspects she has: 1. Transposition of the great vessels. 2. Coarctation of the aorta (COA). 3. Aortic stenosis (AS). 4. Pulmonic stenosis (PS).

2. Coarctation of the aorta (COA). 2. In the older child, COA causes dizziness, headache, fainting, elevated blood pressure, and bounding radial pulses.

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). With COA there is narrowing of the aorta, which increases pressure proximal to the defect (upper extremities) and decreases pressure distal to the defect (lower extremities). There will be high BP and strong pulses in the upper extremities and lowerthan-expected BP and weak pulses in the lower extremities.

8. The nurse is caring for a child who has undergone a cardiac catheterization. During recovery, the nurse notices the dressing is saturated with bright red blood. The nurse's first action is to: 1. Call the interventional cardiologist. 2. Notify the cardiac catheterization laboratory that the child will be returning. 3. Apply a bulky pressure dressing over the present dressing. 4. Apply direct pressure 1 inch above the puncture site.

4. Apply direct pressure 1 inch above the puncture site.

During a well-child checkup for an infant with tetralogy of Fallot (TOF), the child develops severe respiratory distress and becomes cyanotic. The nurse's first action should be to

4. Hold the child in knee-chest position to decrease venous blood return.

What should the nurse recognize as an early clinical sign of compensated shock in a child? Confusion Sleepiness Hypotension Apprehensiveness

Apprehensiveness

The nurse is preparing to give digoxin (Lanoxin) to a 9-month-old infant. The nurse checks the dose; 4 mL of the drug is to be drawn up. Based on the nurse's knowledge of this medication and safe pediatric dosages, the most appropriate action by the nurse is do not draw-up dose; suspect dosage error. mix dose with juice to disguise its taste. check heart rate; administer dose by placing it to the back and side of mouth. check heart rate; administer dose by letting infant suck it through a nipple.

do not draw-up dose; suspect dosage error.

After a patient returns from cardiac catheterization, the nurse notes that the pulse distal to the catheter insertion site is weaker (+1). The most appropriate nursing intervention is to elevate the affected extremity. document the findings and continue to monitor. notify the healthcare provider of the finding. apply warm compresses to the insertion site

document the findings and continue to monitor. The pulse distal to the catheter insertion site may be weaker for the first few hours after catheterization. It should gradually increase in strength. The extremity is kept straight and immobile, but elevation is not necessary. Because a weaker pulse is an expected finding, the nurse should document it and continue to monitor it. There is no need to notify the physician. The insertion site is kept dry. Warm compresses would increase the risk of bleeding from the insertion site.

Surgical repair for patent ductus arteriosus (PDA) is done to prevent the complication of 1. pulmonary infection. 2. right-to-left shunt of blood. 3. decreased workload on left side of heart. 4. increased pulmonary vascular congestion

increased pulmonary vascular congestion

Nursing care of the infant and child with congestive heart failure includes force fluids appropriate to age. monitor respirations during active periods. organize activities to allow for uninterrupted sleep. give larger feedings less often to conserve energy.

organize activities to allow for uninterrupted sleep.

Congenital heart defects have traditionally been divided into acyanotic or cyanotic defects. Based on the nurse's knowledge of congenital heart defects, this system in clinical practice is 1. helpful, because it explains the hemodynamics involved. 2. helpful, because children with cyanotic defects are easily identified. 3. problematic, because cyanosis is rarely present in children. 4. problematic, because children with acyanotic heart defects may develop cyanosi

problematic, because children with acyanotic heart defects may develop cyanosi