N 360 Congenital Heart Defects Pearson questions

A newborn diagnosed with hypoplastic left heart syndrome is scheduled for a heart transplantation. The nurse informs the mother that the transplanted heart usually lasts for how long before another transplant is​ needed?

5 to 9 years 0 to 4 years 16 to 20 years **10 to 15 years RATIONALE: The nurse should inform the mother that a heart transplant usually lasts 10 to 15 yearslong dash—not 0 to 4​ years, 5 to 9​ years, or 16 to 20 yearslong dash—before another transplant is needed.

The nurse is explaining to a student nurse that​ left-to-right shunting of blood in the heart can lead to pulmonary overload and congestive heart failure. Which heart defect could the nurse use as an example in the​ explanation?

Coarctation of the aorta ** Patent ductus arteriosus Tetralogy of Fallot Pulmonic stenosis RATIONALE: The nurse should discuss the pathophysiology of patent ductus arteriosus. This congenital heart defect is associated with increased pulmonary blood flow that occurs as a result of​ left-to-right shunting. Pulmonic stenosis and tetralogy of Fallot are congenital heart defects that are associated with decreased pulmonary blood​ flow, not increased pulmonary blood flow. Coarctation of the aorta results when there is obstructed systemic blood flow.​ Therefore, the nurse should not discuss the pathophysiology of this disorder

The nurse is educating a​ women's community group about congenital heart disorders. Which factor should the nurse identify as placing a child at a greater risk for being born with a congenital heart​ disorder?

Fetal exposure to a bacterial infection Young age of mother Mother infected with gonorrhea **Chromosomal abnormality such as Down syndrome RATIONALE: The nurse should include information about chromosomal abnormalities such as​ Down, Marfan, and DiGeorge​ syndromes, which place the child at a greater risk for being born with a congenital heart disorder. Fetal exposure to a bacterial infection does not place the child at a greater risk for developing a congenital heart disorder because most disorders result from viral infections and metabolic disorders. A mother infected with gonorrhea does not place the child at a greater risk for developing a congenital heart disorder. A​ mother's young age does not place the child at a greater risk for developing a congenital heart disorder.

A newborn diagnosed with truncus arteriosus is prescribed prostaglandin E1​(PGE1). The​ newborn's parents ask how this medication will help their newborn. The nurse bases the response on which​ rationale?

Increases plasma aldosterone **Maintains patencey Decreases preload Improves myocardial contractility RATIONALE:Prostaglandins maintain the patency of the truncus​ arteriosus, allowing mixing to keep the infant partially oxygenated until definitive repair can be done. Cardiac glycosides would be used to improve myocardial contractility. Diuretics decrease preload by working on the kidney. Medications are used to decrease plasma aldosterone in the treatment of congenital heart defects not increase plasma aldosterone which is beneficial in decreasing afterload.

The nurse is caring for a​ school-age client who has undergone cardiac catheterization for repair of an atrial septal defect. Which intervention should the nurse​ implement?

Maintain​ quiet, low exertion activity for 12 hours Keep on bed rest for 2 hours **Observe for signs of decreased perfusion Restrict oral fluids RATIONALE: Observing for signs of decreased perfusion is the intervention the nurse needs to implement after cardiac catheterization. During the​ procedure, the catheter can trigger arteriospasm and​ vasoconstriction, leading to loss of perfusion to the extremity. The child should avoid hip flexion to prevent​ bleeding; therefore, the nurse should keep the child on supine bed rest for 4 to 6​ hours, not just 2​ hours, after cardiac catheterization. The child needs to maintain​ quiet, low exertion activity for 24​ hours, not just 12​ hours, to prevent bleeding following cardiac catheterization. The nurse should encourage​ fluids, not restrict oral​ fluids, because the child is at risk for dehydration after cardiac catheterization.

The nurse is planning care for an​ 18-month-old child diagnosed with tetralogy of Fallot. Which intervention should the nurse implement to assist in managing​ hypercyanosis? ​(Select all that​ apply.)

Place child in supine position **Administer packed red blood cells **Use opioids to manage pain Avoid administering dopamine **Apply oxygen

mmediately after the birth of an​ infant, the nurse is completing a physical assessment. Which manifestation indicates the infant may have a heart defect associated with decreased pulmonary blood​ flow?

Poor feeding **Profound cyanosis that does not respond to oxygen Fatigue Clubbing of fingers and toes RATIONALE: Immediately after the birth of an​ infant, profound cyanosis that does not respond to oxygen is a manifestation of a heart defect associated with decreased pulmonary blood flow.​ Fatigue, clubbing of fingers and​ toes, and poor feeding are manifestations of a heart defect associated with decreased pulmonary blood​ flow; however, these defects are not seen immediately after birth. These manifestations are considered chronic signs and symptoms that may occur if the disorder remains undiagnosed.

The nurse is caring for a client diagnosed with a congenital heart defect. Which item will the nurse include in the psychosocial portion of the nursing​ assessment?

Respiratory rate **Parental coping skills Blood pressure Maternal prenatal history RATIONALE: During the psychosocial portion of the nursing assessment the nurse will assess the coping skills of the parents. Information about the maternal prenatal history is included in the health history. The respiratory rate and blood pressure are assessed during the physical examination.

The nurse is providing education to the parents of an infant diagnosed with aortic stenosis. About which procedure that will be performed via cardiac catheterization in an attempt to open the stenotic valve should the nurse educate the​ parents?

Transcatheter closure Atrial septostomy Patent ductus arteriosus closure **Valvuloplasty RATIONALE: The nurse should educate the parents about a valvuloplasty. This​ procedure, which is performed via cardiac​ catheterization, involves opening the stenotic valve with a balloon that is inflated in the valve. The nurse should not educate the parents about an atrial​ septostomy, patent ductus arteriosus​ closure, or transcatheter closure.

An infant diagnosed with transposition of the great arteries is scheduled for a cardiac catheterization. The nurse prepares the infant for which procedure where a balloon is inserted to make the foramen ovale​ wider?

Transcatheter closure Electrocardiogram Stent **Atrial septostomy RATIONALE: The nurse should prepare the infant for an atrial septostomy. This procedure involves threading a balloon into a vein up to the right atrium during a cardiac catheterization. The balloon is then inflated at the foramen​ ovale, creating a wider​ opening, promoting mixing to maintain some oxygenated blood to the systematic circulation. The nurse should not prepare the client for an​ electrocardiogram, stent, or transcatheter closure.

A newborn recently diagnosed with coarctation of the aorta is admitted to the neonatal intensive care unit​ (NICU). For which clinical manifestation should the nurse monitor the​ client?

Warm extremities Increased urinary output Loud murmur ** Delayed capillary refill RATIONALE: Coarctation of the aorta is a defect that limits cardiac output. The nurse should monitor the infant for clinical manifestations of decreased cardiac​ output, which include delayed capillary​ refill, but do not include a loud​ murmur, increased urinary​ output, or warm extremities.

The nurse is providing care to a child diagnosed with patent ductus arteriosus who is exhibiting symptoms of congestive heart failure. Which intervention is appropriate to decrease the cardiac workload of the​ client? ​(Select all that​ apply.)

Weigh child once a week **Provide frequent rest periods while feeding Offer three large feedings **Burp child frequently during feeding **Strictly measure intake and output RATIONALE: Burping the child frequently and providing frequent rest periods are interventions the nurse should implement because these decrease cardiac workload while feeding. Strictly measuring intake and output is an intervention the nurse should implement because managing the​ child's fluids will prevent fluid overload and decrease cardiac workload. The nurse should implement the intervention to weigh the child at the same time every​ day, not once a week. The nurse should offer frequent small​ feedings, not three large feedings.