Peds from Mom - cardio

3. Hypoplastic left heart syndrome is treated by the Norwood procedure, or heart transplant.

A heart transplant may be indicated for a child with severe heart failure and: 1. Patent ductus arteriosus (PDA). 2. Ventricular septal defect (VSD). 3. Hypoplastic left heart syndrome. 4. Pulmonic stenosis (PS).

2. Checking for pulses, especially in the canulated extremity, would assure perfusion to that extremity and is the priority post procedure.

A 10-year-old has undergone a cardiac catheterization. At the end of the procedure, the nurse should first assess: 1. Pain. 2. Pulses. 3. Hemoglobin and hematocrit levels. 4. Catheterization report.

1. Beta blockers are used with caution in patients with hyperlipidemia, hyperglycemia, and impotence.

A 16-year-old being treated for hypertension has laboratory values of hemoglobin B 16 g/dL, hematocrit level 43%, sodium 139 mEq/L, potassium 4.4 mEq/L, and total cholesterol of 220 mg/dL. Which drug does the nurse suspect the patient takes based on the total cholesterol? 1. Beta blockers. 2. Calcium channel blockers. 3. ACE inhibitors. 4. Diuretics.

D Wear goggles and a mask Caregiver contact with ribavirin may lead to headaches, burning eyes and mucous membranes, and crystallization of soft contact lenses. Gowns and hair nets are not necessary.

A child with respiratory syncytial virus (RSV) is receiving ribavirin (Virazole), and requires an oxygen tent. Which precaution will the nurse specifically take while caring for the child? A Wear a gown B Wear a mask C Wear a gown and hair net D Wear goggles and a mask

Kawasaki disease or KD.

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 _____________________.

D Position the child with the knees to the chest The knee-chest position reduces venous return from the legs and reduces blood shunting through the septal defect, thus increasing the oxygen content of the systemic circulation and decreasing dyspnea. A sedative may be necessary if positioning is ineffective. Assessment should be done after positioning. Explanations or reassurances will not relieve hypoxia.

A 2-year-old child with tetralogy of Fallot becomes upset during a routine blood draw. The child turns blue and the respiratory rate increases to 45 breaths per minute. Which of the following interventions should the nurse do first? A Notify the provider and request sedation B Assess for irregular heart rhythm and rate C Reassure the child that the pain will be mild D Position the child with the knees to the chest

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

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

A Maintain the child in an undisturbed, upright position Sudden onset of these symptoms likely indicates epiglottitis. The child is at high risk for airway obstruction, and should be left alone in an upright position to avoid further irritation of the epiglottis until the need for intubation or tracheotomy is determined. Because of the potential for airway obstruction and respiratory interventions, the child should not eat or drink anything.

A 3-year-old child is brought to the emergency room. The child's mouth is open, and he is drooling and lethargic. The mother reports these symptoms began suddenly within the last 2 hours. Which intervention should the nurse perform first? A Maintain the child in an undisturbed, upright position B Assess the child's throat using a small tongue depressor C Obtain intravenous access and draw blood cultures D Provide cool liquids to soothe the child's throat and provide hydration

Tetralogy of Fallot or TOF.

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

1. CHD is found often in children with Down syndrome

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.

C Swimming Swimming promotes cardiac health, increases ventilation and perfusion by requiring controlled breathing and enhances skeletal muscle mass. Activities that require frequent stop/start exertions can trigger asthmatic exacerbations.

A child diagnosed with asthma states she would like to join a school sports team. Which sport would be most appropriate? A Soccer B Track C Swimming D Cheerleading

1. The rubbing of the child's eyes may mean that she is seeing halos around the lights, indicating digoxin toxicity. The HR is slow for her age and also indicates digoxin toxicity. A decrease in serum potassium because of the furosemide can increase the risk for digoxin toxicity

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 beats per minute. The nurse expects which laboratory finding? 1. Hypokalemia. 2. Hypomagnesemia. 3. Hypocalcemia. 4. Hypophosphatemia.

2. The beta blocker not only affects the heart and lungs but also blocks the beta sites in the liver, reducing the amount of glycogen available for use, causing hypoglycemia. The lower HR and BP also suggest ingestion of a cardiac medication.

A child has a Glasgow Coma Scale of 3, HR of 88 beats per minute and regular, respiratory rate of 22, BP of 78/52, and blood sugar of 35 mg/dL. The nurse asks the caregiver about accidental ingestion of which drug? 1. Calcium channel blocker. 2. Beta blocker. 3. ACE inhibiter. 4. ARB.

4. Valvular involvement indicates significant damage, so antibiotics would be taken for the rest of her life.

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."

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

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.

Patent ductus arteriosus or PDA.

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 _____________________.

1. Formula can be supplemented with extra calories, either from a commercial supplement, such as Polycose, or from corn syrup. Calories in formula could increase from 20 kcal/oz to 30 kcal/oz or more.

A nursing action that promotes ideal nutrition in an infant with congestive heart failure (CHF) is: 1. Feeding 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.

4. SVT is often above 200 and a result of dehydration, which a vomiting child could have. The rapid rate causes a low CO, resulting in low BP and prolonged capillary refill.

A toddler who has been hospitalized for vomiting due to gastroenteritis is sleeping and difficult to wake up. Assessment reveals vital signs of a regular HR of 220 beats per minute, respiratory rate of 30 per minute, BP of 84/52, and capillary refill of 3 seconds. Which dysrhythmia does the nurse suspect in this child? 1. Rapid pulmonary flutter. 2. Sinus bradycardia. 3. Rapid atrial fibrillation. 4. Supraventricular tachycardia.

2. Children with spina bifida (myelo - meningocele) often have a latex allergy. The catheter balloon is often made of latex, and all personnel caring for the patient should be made aware of the allergy.

An 18-month-old with a myelomeningocele is undergoing a cardiac catheterization. The mother expresses concern about the use of dye in the procedure. The child does not have any allergies. In addition to the concern for an iodine allergy, what other allergy should the nurse bring to the attention of the catheterization staff? 1. Soy. 2. Latex. 3. Penicillin. 4. Dairy.

A Obtain a peak flow reading More assessment is needed. The nurse should obtain a peak flow reading and other vital signs before calling a parent or instructing the adolescent to lie down. Since the adolescent has not experienced any asthma-related problems for quite some time, administering a bronchodilator would be inappropriate at this time.

An adolescent with a history of asthma reports feeling chest pain to the school nurse. The nurse determines the adolescent has not had asthmatic problems in years. Which of the following should the nurse do next? A Obtain a peak flow reading B Instruct the adolescent to lie down for 30 minutes C Call a parent for more information D Give two puffs of a short-acting bronchodilator

C Because these infants become extremely fatigued while sucking, small frequent feedings with adequate rest periods can improve their total intake.

An appropriate nursing action to include in the care of an infant with congenital heart disease who has been admitted with heart failure is: A Positioning flat on the back B Encouraging nutritional fluids C Offering small frequent feedings D Measuring the head circumference

B Flexing the hips and knees decreases venous return to the heart from the legs; when venous return to the heart is decreased, the cardiac workload is decreased.

An infant with tetralogy of Fallot becomes cyanotic and dyspneic after a crying episode. To relieve the cyanosis and dyspnea, the nurse should place the infant in the: A Orthopneic position B Knee-chest position C Lateral Sims' position D Semi-Fowler's position

C Scheduling care to provide for uninterrupted rest periods Organizing nursing care to provide for uninterrupted periods of sleep reduces cardiac demand. Option A: Feeding time should be restricted to a maximum of 45 minutes or discontinued sooner if the infant tires.Option B: In an attempt to get her own way. the child may cry. Excessive crying should be limited; however. appropriate limit setting should still be observed.Option D: Developing and implementing a consistent care plan can be important. but it is not related to decreasing cardiac demands or workload.

Appropriate intervention is vital for many children with heart disease in order to go on to live active. full lives. Which of the following outlines an effective nursing intervention to decrease cardiac demands and minimize cardiac workload? A Feeding the infant over long periods B Allowing the infant to have her way to avoid conflict C Scheduling care to provide for uninterrupted rest periods D Developing and implementing a consistent care plan

A, B, and D. Option C is wrong because this condition can be treated with both palliative surgery (used to help alleviate symptoms until the child is old enough for complete repair) and complete repair. All the other options are correct.

As the nurse you know which statements are TRUE about Tetralogy of Fallot? Select all that apply:* A. "Tetralogy of Fallot is a cyanotic heart defect." B. "In this condition the heart has to work harder to pump blood to the lungs, which cause the right ventricle to work harder and enlarge." C. "Tetralogy of Fallot is treated with only palliative surgery." D. "Many patients with this condition will experience clubbing of the nails."

2. Joint inflammation is experienced in RF; aspirin therapy helps with inflammation and pain.

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

2. Age 3 years is the recommended age to establish a baseline BP in a normal healthy child

BP screenings to detect end-organ damage should be done routinely beginning at what age? 1. Birth. 2. 3 years. 3. 8 years. 4. 13 years.

B Absent or diminished femoral pulses Absent or diminished femoral pulse is a classic characteristic of coarctation of aorta.Option C: Severe cyanosis at birth is seen in such defects as transposition of the great vessels.Option A. D: Tet episodes and squatting are characteristic of tetralogy of Fallot.

Bryce is a child diagnosed with coarctation of aorta. While assessing him. Nurse Zach would expect to find which of the following? A Squatting posture B Absent or diminished femoral pulses C Severe cyanosis at birth D Cyanotic ("tet") episodes

C Normal weight for age Option A: Daily use of antibiotic is not indicated in heart failure. Option B. A pulse rate less than 50 beats/minute. bradycardia. probably indicates digoxin toxicity. Option D: An elevated RBC count demonstrates polycythemia

Clay is an 8-year-old boy diagnosed with heart failure. Which of the following shows that he is strictly following the directed therapeutic regimen? A Daily use of an antibiotic B Pulse rate less than 50 beats/minute C Normal weight for age D Elevation in red blood cell (RBC) count

3, 4, 5, 6. 3. Heart defects are now classified as defects with increased or decreased pulmonary blood flow. 4. Heart defects are now classified as defects with increased or decreased pulmonary blood flow. 5. Heart defects are now classified as defects with increased or decreased pulmonary blood flow. 6. Heart defects are now classified as defects with increased or decreased pulmonary blood flow.

Congenital heart defects (CHDs) are classified by which of the following? Select all that apply. 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.

True

Decreased urinary output (fewer wet diapers or less frequent toileting) may be a sign of worsening heart failure. True False

100

Do not administer Digoxin (lanoxin) if heart rate is less than ____ in an infant (numeric response only)

4. The increase in the SVR would increase afterload and increase blood return to the pulmonary artery

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: 1. Lay the child flat to promote hemostasis. 2. Lay the child flat with legs elevated to increase blood flow to the heart. 3. Sit the child on the parent's lap, with legs dangling, to promote venous pooling. 4. Hold the child in knee-chest position to decrease venous blood return.

3. The toddler will naturally assume this position to decrease preload by occluding venous flow from the lower extremities and increasing afterload. Increasing SVR in this position increases pulmonary blood flow

During play, a toddler with a history of tetralogy of Fallot (TOF) might assume which position? 1. Sitting. 2. Supine. 3. Squatting. 4. Standing.

1, 2, 3, 4, 6. 1. Hypoxia causes polycythemia, which can lead to increased blood viscosity, which can lead to blood clots and a stroke. 2. Hypoxia causes polycythemia, which can lead to increased blood viscosity, which can lead to blood clots and a stroke. 3. Hypoxia causes polycythemia, which can lead to increased blood viscosity, which can lead to blood clots and a stroke. 4. Developmental delays can be caused by multiple hospitalizations and surgeries. The child usually catches up to the appropriate level. 6. Brain damage can be caused by hypoxia, blood clots, and stroke.

Hypoxic spells in the infant with a congenital heart defect (CHD) can cause which of the following? Select all that apply. 1. Polycythemia. 2. Blood clots. 3. Cerebrovascular accident. 4. Developmental delays. 5. Viral pericarditis. 6. Brain damage. 7. Alkalosis.

True It allows most of the blood from the right ventricle to bypass the fetus' fluid-filled lungs, protecting the lungs from being overworked and allowing the right ventricle to strengthen.

In the developing fetus, the ductus arteriosus (DA), is a shunt connecting the pulmonary artery to the aortic arch. True False

D Apex The blunt. rounded point of the heart is the apex.Option A: The larger. flat portion at the opposite is the base.Option B: The pericardium is also called the pericardial sac. It has a fibrous outer layer and a thin inner layer that surrounds the heart.Option C: The aorta is the largest artery that carries blood from the left ventricle to the body.

It is considered as the bluntly rounded portion of the heart A Base B Pericardium C Aorta D Apex

True

Marfan syndrome is a congenital defect sometimes associated with CHD. Affected persons have valvular problems, increased dilation of the Aorta, are tall and lean in stature with a "wingspan" that exceeds their height. Abe Lincoln was thought to have Marfan syndrome. True False

A Replacing regular nipples with easy-to-suck ones The nurse should replace regular nipples with easy-to-suck-ones because the infant may tire instantly with regular nipples and thus would not be able to suck sufficiently.Option B. C: Also to prevent tiring. small frequent feedings lasting no more than 45 minutes. rather than large evenly spaced feedings or ones lasting longer than 1 hour. should be given.Option D: Typically. the infant receives a low-sodium. high-calorie diet

Mr. and Mrs. Baker's only daughter is diagnosed with heart failure. Which of the following interventions would be appropriate to promote optimal nutrition for the infant? A Replacing regular nipples with easy-to-suck ones B Allowing the infant to feed for at least 1 hour C Providing large feedings evenly spaced every 4 hours D Offering formula that is high in sodium and calories

False Newborn K+ 3-6 mEq/L Older: 3.5-5.0 mEq/L

Normal K+ levels are the same for newborns and older children/adults True False

True

Per our notes: Breathing stimulates the closure of the Ductus arteriosis. True False

B Ventricular septal defect. overriding aorta. pulmonic stenosis (PS). and right ventricular hypertrophy The defects associated with tetralogy of Fallot include ventricular septal defect. overriding aorta. pulmonic stenosis (PS). and right ventricular hypertrophy.Option A: The aorta exiting from the right ventricle with no communication between the systemic and pulmonic circulation describes the defects associated with transposition of the great vessels.Option C: Coarctation of aorta and aortic and mitral valve stenosis are defects associated with tricuspid atresia. Severe coarctation of aorta. severe aortic valvular stenosis or atresia. and severe mitral valve stenosis or atresia are defects associated with hypoplastic left heart syndrome.Option D: Also. the left ventricle. aortic valve. mitral valve. and ascending aorta usually are small or hypoplastic.

The Foley Family is caring for their youngest child. Justin. who is suffering from tetralogy of Fallot. Which of the following are defects associated with this congenital heart condition? A Aorta exits from the right ventricle. pulmonary artery exits from the left ventricle. and two noncommunicating circulations B Ventricular septal defect. overriding aorta. pulmonic stenosis (PS). and right ventricular hypertrophy C Coarctation of aorta. aortic valve stenosis. mitral valve stenosis. and patent ductus arteriosus D Tricuspid valve atresia. atrial septal defect. ventricular septal defect. and hypoplastic right ventricle

B When the child squats, blood pools in the lower extremities because of flexion of the hips and knees; less blood returns to the hear, enabling the heart to beat more effectively.

The mother of a child with a congenital cardiac defect asks the nurse why her child squats after exertion. The nurse should reply that this position: A Reduces muscle aches B Increases cardiac efficiency C Enhances the pull of gravity D Decreases blood volume in the extremities

A A cardiac catheterization will identify the exact location of the VSD as well as assess pulmonary pressures.

The nurse explains to the parents of a 5 year old with a VSD that a cardiac cath has been scheduled to: A Identify the specific location of the defect B Determine the degree of cardiomegaly present C Confirm the presence of a pansystolic murmur D Establish the presence of ventricular hypertrophy

C Clear the airway Cardiopulmonary resuscitation should always begin with clearing the airway, if the collapse of the person was not witnessed. Unconsciousness and apnea in children is most likely due to respiratory pathophysiology, so airway and breathing should be addressed before chest compressions. For this reason also, precordial thumps are rarely indicated for children.

The nurse finds a 4-year-old child not breathing. Which intervention should the nurse do first? A Give a precordial thump B Begin giving breaths with a bag-valve-mask at a rate of 16 breaths per minute C Clear the airway D Start chest compressions at a rate of 100 per minute

D With transposition of the great vessels, the pulmonary artery is attached to the left ventricle and the aorta is attached to the right ventricle. The child is cyanotic because blood reaches the tissues from the right ventricle before being oxygenated by the lungs. In atrial septal defect and ventricular septal defect, blood is shunted from the left side of the heart to the right side through patent openings. Because the blood travels from left to right, it's oxygenated and doesn't produce cyanosis. Coarctation of the aorta is a narrowing of the aorta that decreases the circulation of oxygenated blood to the body. With this condition, the child won't be cyanotic unless cardiac output drops.

What congenital heart defect causes cyanosis in children? A Atrial septal defect B Coarctation of the aorta C Ventricular septal defect D Transposition of the great vessels

C Obstruction of blood flow from the right ventricle PS refers to an obstruction of blood flow from the right ventricle.Option A: Truncus arteriosus involves a single vessel arising from both ventricles.Option D: Total anomalous pulmonary venous communications involve the return of blood to the heart without entry into the left atrium and obstruction of blood flow from the left ventricle.

When creating a teaching program for the parents of Jessica who is diagnosed with pulmonic stenosis (PS). Nurse Alex would keep in mind that this disorder involves which of the following? A A single vessel arising from both ventricles B Obstruction of blood flow from the left ventricle C Obstruction of blood flow from the right ventricle D Return of blood to the heart without entry to the left atrium

B A difference in pulse amplitude between the upper and lower extremities or between the femoral and radial pulses suggests a coarctation of the aorta (narrowing of the aorta below the left subclavian artery). A patent ductus arteriousus is associated with a bounding pulse due to left-to-right shunting of blood in the heart. A weak or thinner pulse indicates diminished cardiac output.

When palpating the brachial, radial, and femoral pulses of a neonate, the nurse notes a difference in pulse amplitude between the femoral and radial pulses bilaterally. This difference suggests: A Patent ductus arteriosus B Coarctation of the aorta C Diminished cardiac output D Left to right shunting in the heart.

A A 3-month-old infant Infants between 2 and 4 months are at highest risk for SIDS. Older parents and respiratory infections have not been proven to increase SIDS risk. Episodes of apnea longer than 20 seconds have been shown to indicate higher SIDS risk.

Which child is at greatest risk for sudden infant death syndrome (SIDS)? A A 3-month-old infant B A 6-month-old infant who has had 2 bouts of pneumonia C A first-born child of a 45-year-old mother D A 2-year-old with frequent episodes of 5-second apnea

C For kawasaki disease, aspirin is given initially in an anti-inflammatory dose to control fever and symptoms of inflammation. When fever has subsided, aspirin is continued at an antiplatelet dose. If the child develops coronary abnormalities, salicylate therapy is continued indefinitely. Acetaminophen and ibuprofen aren't used because they don't thin the blood. Amoxicillin is an antibiotic, and antibiotics aren't effective in treating kawasaki disease.

Which medication is usually given to children diagnosed with Kawasaki disease? A Acetaminophen (Tylenol) every 4 hours B Amoxicillin (Amoxil) divided into three daily doses C Aspirin daily D Ibuprofen (Motrin) every 6 to 8 hours

B. The patient will have a harsh systolic murmur due to pulmonary stenosis, which would lead you to find the murmur at the LEFT of the sternal border (the sound location of the pulmonary valve).

You are assessing the heart sounds of a patient with a severe case of Tetralogy of Fallot. You would expect to hear a __________ murmur at the _______ of the sternal border?* A. diastolic; right B. systolic; left C. diastolic; left D. systolic; right

D Telling the parents about the sequence of events before and after surgery will decrease their anxiety and increase cooperation. The nurse should listen to the parents' concerns, rather than dismissing them by telling them not to worry. It isn't appropriate to obtain an order for anti-anxiety medication for the parents. Children do best with preoperative teaching 3 to 7 days before a procedure rather than 1 month before.

Which nursing intervention best helps decrease anxiety for the parents of a child scheduled for cardiac surgery? A Tell the parents not to worry, because the physician performs this procedure all the time. B Obtain an order for anti-anxiety medication for the parents, if requested. C Teach the parents and the child about the surgery 1 month before the procedure D Explain the steps that will occur before and after surgery. The parents need something tangible to focus on.

A, B & C Administration:Direct to the side of the mouth and rinse with water.

Which of the following are correct statements regarding Digoxin (Lanoxin)? Check all that apply. A. Digoxin is the drug of choice to improve myocardial contractility B. Often prescribed to increase contractility and decrease afterload C. ALWAYS check dose with another Registered Nurse before administration D. Administration is normally IV for infants

B Fried chicken Cystic fibrosis clients should have high-nutrient, low-fat diets, since fats are especially difficult for these clients to digest. Fried foods should be avoided.

Which of the following foods would not be appropriate for a client with cystic fibrosis? A Roasted pork tenderloin B Fried chicken C Skim milk shake D Egg omelet

A Treating streptococcal throat infections with an antibiotic Rheumatoid fever results from improperly treated group beta-hemolytic streptococcal infections. usually pharyngitis. Therefore. prompt treatment of streptococcal throat infections with an antibiotic is a key preventive measure.Option B: Initial prevention is not possible once the child has rheumatic fever. However. the child will be treated with penicillin to prevent a recurrence of streptococcal infections.Option C: A corticosteroid may be used to reduce inflammation during treatment of rheumatic fever. not as a preventive measure.Option D: An antibiotic is given to children with cardiac disease to prevent carditis. not rheumatic fever.

Which of the following instructions would Nurse Courtney include in a teaching plan that focuses on initial prevention for Sheri who is diagnosed with rheumatic fever? A Treating streptococcal throat infections with an antibiotic B Giving penicillin to patients with rheumatic fever C Using corticosteroid to reduce inflammation D Providing an antibiotic before dental work

C Heart murmur Heart murmurs are present in about 75% of clients during the first week of carditis, and 85% in the second week. Chest wall pain or hypotension is not typical with carditis. Tachycardia may be present, but the rhythm is usually regular.

Which of the following is an initial sign of carditis in a child diagnosed with rheumatic fever? A Anterior chest wall pain B Irregular heart rhythm C Heart murmur D Low blood pressure

C Use of prophylactic antibiotics before any dental procedures Prophylactic antiobiotics before dental procedures are recommended for clients with heart defects to reduce the risk of bacterial infection. Activities are generally not restricted after discharge, and stitches are not needed following cardiac catheterization. Normal bathing or showering is allowed.

Which of the following should the nurse include in a discharge teaching plan for parents of a child who has undergone cardiac catheterization for a ventricular septal defect (VSD)? A Restriction of the child's activities for 2 weeks following the procedure B Sponge bathing until the stitches are removed C Use of prophylactic antibiotics before any dental procedures D Use of a pressure dressing until the health care provider has evaluated the site

C Extreme bradycardia Extreme bradycardia is a cardinal sign of digoxin toxicity.Option A. B. D: Headache. respiratory distress. and constipation are not related to digoxin toxicity.

Which of the following would Nurse Tony suppose to regard as a cardinal manifestation or symptom of digoxin toxicity to his patient Clay diagnosed with heart failure? A Headache B Respiratory distress C Extreme bradycardia D Constipation

D. Alprostadil, prostaglandin E, will keep the ductus arteriosus open after birth. This will help with keeping the oxygen levels up because it allows more blood to flow to the lungs that is oxygenated via the ductus arteriosus. Remember this usually closes shortly after birth, but in a patient with severe Tetralogy of Fallot this opening needs to stay opened until surgery can be performed.

You're caring for a newborn who has Tetralogy of Fallot with severe cyanosis. You anticipate the newborn will be started on ___________?* A: Indomethacin B. Diclofenac C. Celecoxib D. Alprostadil

A. This statement is INCORRECT. It should say: "Unoxygenated blood enters through the superior and inferior vena cava to the RIGHT (not left) atrium.

You're providing an in-service to a group of new nurses who will be caring for patients who have Tetralogy of Fallot. Which statement below is INCORRECT concerning how the blood normally flows through the heart?* A. Unoxygenated blood enters through the superior and inferior vena cava and travels to the left atrium. B. The pulmonic valve receives blood from the right ventricle and allows blood to flow to the lungs via the pulmonary artery. C. The left atrium allows blood to flow down through the bicuspid valve (mitral) into the left ventricle. D. Oxygenated blood leaves the left ventricle and flows up through the aortic valve and aorta to be pumped to the rest of the body.