EAQ Pediatric Perfusion

Electrocardiography (ECG) is scheduled for an infant who has tetralogy of Fallot. The mother asks the nurse what type of test this is and why it is done. Which is the best response by the nurse? A. "It's a type of x-ray that shows us the size of the baby's heart." B. "Electrical activity in the baby's heart is recorded, then printed on graph paper." C. "It's an ultrasound procedure that produces images of the structures in the baby's heart." D. "Contrast material is injected into the baby's vein to visualize the flow of blood through the heart."

B. "Electrical activity in the baby's heart is recorded, then printed on graph paper."

Heart failure develops in a 4-month-old infant with a congenital heart defect, and the infant exhibits marked dyspnea at rest. Which assessment finding would the nurse expect in this infant? A. Hypovolemia B. Bilateral Crackles C. A decreased Red blood cell count D. Decreased pH and carbon dioxide values

B. Bilateral Crackles

A 3-month-old infant with tetralogy of Fallot suddenly becomes cyanotic and begins breathing rapidly. In which position would the nurse immediately place the infant? A. Supine B. Lateral C. Knee-chest D. Semi-Fowler

C. Knee-chest

The nurse is assessing a newborn with suspected retention of a fetal structure that will result in a congenital heart defect. Which fetal structures should undergo change after birth? Select all that apply. One, some, or all responses may be correct. A. Mitral valve B. Foramen Ovale C. Pulmonary veins D. Ductus arteriosus E. Pulmonary arteries

B. Foramen Ovale D. Ductus arteriosus

Which would the nurse expect to see when reviewing the results of a complete blood count for an infant with tetralogy of Fallot? A. Anemia B. Polycythemia C. Agranulocytosis D. Thrombocytopenia

B. Polycythemia

The nurse assesses a newborn and observes central cyanosis. Which type of congenital heart defect usually results in central cyanosis? A. Shunting of blood from left to right B Shunting of blood from right to left C. Obstruction of blood flow from the left side of the heart D. Obstruction of blood flow between the left and right sides of the heart

B Shunting of blood from right to left

A 2-year-old child who is hospitalized for repair of tetralogy of Fallot is seen squatting in the playroom. In response to this behavior, which would the nurse do? A. Administer oxygen through a mask. B. Call the respiratory therapist for a nebulizer treatment C. Continue to observe the child if there are no other signs of distress D. Notify the health care provide that the child's condition is deteriorating

C. Continue to observe the child if there are no other signs of distress

In which position would the nurse place a 5-week-old infant who has difficulty breathing and feeding related to a suspected congenital heart defect? A. supine, with knees flexed B. Orthopneic, with pillows for support C. Side-lying, with the upper body elevated D. Prone, with the head supported by pillows

C. Side-lying, with the upper body elevated

Cardiac catheterization in a child with a ventricular septal defect (VSD) serves which purpose? A. Identifies the specific location of the defect B. Confirms the presence of a pansystolic murmur C. Reveals the degree of cardiomegaly that is present D. Establishes the presence of ventricular hypertrophy

A. Identifies the specific location of the defect

Which clinical manifestation would the nurse recognize as common in tetralogy of Fallot? A. Slow respiration B. Clubbing of fingers C. Decreased red cell counts D. Subcutaneous hemorrhages

B. Clubbing of fingers

An infant with a congenital heart defect is in heart failure and is receiving daily weight measurements. Which complication of heart failure would daily weights help monitor? A. Renal failure B. Fluid retention C. Digitalis toxicity D. Protein malnutrition

B. Fluid retention

A child has a congenital cardiac malformation that causes right-to-left shunting of blood through the heart. Which clinical finding would the nurse expect? A. Proteinuria B. Peripheral Edema C. Increased Hematocrit D. Absence of Pedal pulses

C. Increased Hematocrit

Which early sign of heart failure would the nurse recognize in an infant who has a congenital heart defect with left-to-right shunting of blood? A. Cyanosis B. Restlessness C. Decreased Heart rate D. Increased Respiratory rate

D. Increased Respiratory rate

An infant with congenital heart disease is prescribed digoxin and furosemide upon discharge. Which sign would the nurse instruct the parents to be alert for? A. Difficulty feeding with vomiting B. Cyanosis During periods of crying C. Daily naps lasting more than 3 hours D. A pulse rate faster than 100 bpm

A. Difficulty feeding with vomiting

In which position would the nurse place an infant with tetralogy of Fallot who begins to cry and exhibits worsening cyanosis and dyspnea? A. Knee-chest B. Orthopenic C. Lateral sims D. Semi-Fowler

A. Knee-chest

The parents of a preschooler with a congenital heart defect asks the nurse why their child squats after exertion. Which rationale would the nurse provide the parents? A. Decreases the number of muscle aches B. Improves walking capacity and hip mobility C. Reduces how hard the heart must work D. Helps more blood return to the heart

C. Reduces how hard the heart must work

Which physical examination finding would the nurse expect when assessing an infant with a ventricular septal defect (VSD)? A. Bradycardia at rest B. Activity- related cyanosis C. Bounding peripheral pulses D. Murmur at the left sternal border

D. Murmur at the left sternal border

An infant is born with a life-threatening congenital heart defect and is admitted to the neonatal intensive care unit. Which is the priority nursing intervention at this time? A. Having the hospital chaplain visit the parents B. Assisting the parents with the grieving process C. Obtaining a prescription for a sedative to ease the parents' anxiety D. Arranging for a social worker to talk to the parents about available resources

B. Assisting the parents with the grieving process

Which would the nurse avoid in an infant with a congenital heart defect after cardiac catheterization? A. Offering fluids as tolerated B. Performing ROM exercises C. Monitoring the apical pulse for rate and rhythm D. Assessing the pulses distal to the catheterization site

B. Performing ROM exercises

A 3.5-year-old boy with tetralogy of Fallot just began to walk unsupported. Which developmental assessment would the nurse make about the child? A. Has started to walk at the appropriate age B. Should have started to walk about 2 years earlier C. Demonstrates a mild delay in starting to walk D. Probably walked by holding on at 24 to 30 months of age

B. Should have started to walk about 2 years earlier

Which anatomic abnormalities are found in tetralogy of Fallot? A. Overriding aorta, aortic stenosis, patent ductus arteriosus, and mitral insufficiency are the components of this defect. B. Tricuspid atresia, ventricular septal defect, atrioventricular canal, and coarctation of the aorta are the components of this defect. C. The disorder consists of right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta. D. The disorder consists of right ventricular hypertrophy, atrial septal defect, patent ductus arteriosus, and mitral insufficiency.

C. The disorder consists of right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta.

A 6-month-old infant has a congenital right-to-left shunt defect of the heart. Which clinical finding would the nurse expect during physical examination and review of the child's laboratory reports? Select all that apply. One, some, or all responses may be correct. A. Orthopnea B. Tissue hypoxia C. Increased hematocrit D. Frequent respiratory infections E. Bounding pulses in the upper extremeties

B. Tissue hypoxia C. Increased hematocrit

The weight of a 3-month-old infant with tetralogy of Fallot has declined from the 25th percentile to the 5th. Which mechanism would the nurse suspect is the reason for this inadequate weight gain? A. Cyanosis resulting in cerebral changes B. Decreased arterial oxygen level resulting in polycythemia C. Pulmonary hypertension resulting in recurrent respiratory infections D. Inadequate oxygen perfusion leading to activity intolerance, resulting in diminished energy to nurse

D. Inadequate oxygen perfusion leading to activity intolerance, resulting in diminished energy to nurse

Which nursing care would the nurse provide an 8-month-old infant with tetralogy of Fallot? A. Restriction of fluid intake to conserve energy B. Provision of iron-fortified formula to prevent anemia C. Administration of coagulants to control bleeding tendencies D. Prevention of increased respiratory effort to promote oxygenation

D. Prevention of increased respiratory effort to promote oxygenation