Peds from Mom - Cardio 2
C Postductal coarctation of the aorta causes several changes in the lower extremities: diminished peripheral pulses, hypotension, and resulting cool temp. A child under age 3 can't describe his symptoms, but may exhibit exceptional irritability (rather than lethargy). High blood pressure in the upper portions of the body produces headache and vertigo. Pedal edema isn't related to diminished perfusion of the lower extremities.
1-year-old with postductal coarctation of the aorta is admitted to the acute care unit for treatment. When performing an assessment, the nurse finds that the lower extremities are cool. Which finding should the nurse anticipate as the assessment continues? A Lethargy B Low blood pressure in the arms C Low blood pressure in the legs D Bilateral pedal edema
B Cocaine use can cause tachycardia, hypertension, coronary artery spasm with infarction, and pneumothorax resulting in severe, acute chest pain. Exercise, smoking, and family hx of MI can be addressed after the danger of cocaine-related complications has been eliminated.
16 year old is admitted to the emergency department with complaints of sudden, severe chest pain. He says that he didn't experience any recent trauma to the chest. What should the nurse next ask about? A Exercise and weight lifting B Cocaine use C Smoking D Family history of myocardial infarction (MI)
B Parents should encourage normalcy within the limits of the child's condition. The child needs to have appropriate limits and discipline, but being too strict or overindulging the child makes it hard for him to learn acceptable behavior. A 1 year old child is beginning to explore his world and needs to have activities with other children.
A 1 year old child is diagnosed with a congenital heart defect after cardiac catheterization. His parents express concern about activities at home. Which is the nurse's best response? A "You'll have to establish strict discipline so that he learns what he can't do". B "Allow him to play and be active as long as he doesn't get fatigued". C "He'll only be able to play by himself." D "Discipline and limit-setting need to be relaxed to reduce his stress and crying."
C Early signs of heart failure include tachycardia, sudden weight gain, scalp sweating, and weak peripheral pulses. Weight gain can indicate venous congestion. Tachycardia occurs with heart failure as the heart's workload increases. Weak peripheral pulses are a sign of heart failure.
A 12 year old is diagnosed with hypertension. The nurse understands that hypertension may lead to heart failure. Which assessment finding indicates that the child may have developed heart failure? A Weight loss B Bradycardia C Sudden weight gain D Bounding peripheral pulses
C The increased blood volume and pressure in the lungs resulting from left ventricular failure causes pulmonary edema; dyspnea, and early sign of failure, is probably caused by the decreased distensibility of the lungs.
A 4-month old infant who has a congenital heart defect develops heart failure and is exhibiting marked dyspnea at rest . The nurse is aware this finding can be attributed to: A Anemia B Hypovolemia C Pulmonary edema D Metabolic acidosis
A Child will return from surgery with ET tube and nurse should check for bilateral breath sounds to evaluate tube placement.
A child is in the pediatric intensive care unit immediately after cardiac surgery. Which nursing action is most important? A Assess the airway. B Administer sedation C Maintain semi-Fowler's position. D Monitor oxygen saturation readings
D Kawasaki disease is a type of vasculitis affecting small to medium sized vessels. It primarily affects the lymph nodes but may progress to the coronary arteries. A child with Kawasaki disease has afever for at least five days along with an erythematous rash, red tongue, and red, cracked dry lips. Irritability, not lethargy is seen in Kawasaki disease, along with decreased appetite and edema of the hands and feet. Respiratory congestion isn't a common symptom.
A child is suspected of having Kawasaki disease. Which finding is significant? A Extreme lethargy B Increased appetite C Respiratory congestion D Fever for at least 5 days
A Upon discharge, parents should be taught to call the physician before the child has dental care. The child may be at risk for bacterial endocarditis after surgery, and dental procedures are a common portal of entry for bacteria. The physician may order antibiotics before a dental procedure.
A child underwent cardiac surgery and the nurse must prepare his parents for discharge. Which discharge instruction is correct? A "Call your doctor before your child has dental care." B "Keep your child away from other children for 6 months." C "if your child vomits his digoxin, he may need a second dose". D "Encourage the child to participate in activities so he can develop normally."
B The body responds to the chronic hypoxia caused by the heart defect by increasing the production of red blood cells in an attempt to increase the oxygen-carrying capacity of the blood.
A complete blood workup is ordered for a 5 month old with tetralogy of Fallot. Because of the infant's heart disease, the nurse would expect the report to show: A Anemia B Polycythemia C Agranulocytosis D Thrombocytopenia
A vomiting is a sign of digoxin toxicity. Palpitations and increased heart rate indicate that digoxin is needed. The serum level is within the normal range.
A nine year old received digoxin (Lanoxin) daily for the past 5 days of his hospitalization. Before giving him his dose this morning, the nurse performs a routine assessment. Which assessment finding indicates the need to hold the child's morning dose of digoxin? A Vomiting B Palpitations C Increased heart rate D Serum digoxin level of 1.2 ng/mL
A the minimal hourly urine output should be at least 30 mL/hr for an adult or a child. The normal heart rate for a 5 yr old is 70 to 90 bts minute. Adequate cap refill time is 3 to 5 seconds. Crackles are an abnormal finding and may indicate hypervolemia, or excess circulating fluid volume, and heart failure.
A nurse is assessing a 5 year old with a history of heart failure. Which finding indicates that the child has adequate cardiac output? A Urine output of 30 mL/h B Heart rate of 120 beats/min C Cap refill time of 10 to 15 sec D Bilateral crackles heard on auscultation.
A digoxin slows the heart rate and strengthens contractions; it shouldn't be given if the heart rate is abnormally low with regard to the child's age. The most accurate measure of the child's heart rate is the apical (not radial) pulse. Urine output and blood pressure don't need to be assessed before digoxin administration.
A nurse is caring for a nine year old experiencing tachycardia due to myocarditis. Digoxin (lanoxin) is prescribed. Before giving digoxin to this child, the nurse should assess: A Apical pulse B Urine output C Radial pulse D Blood pressure
D bleeding from the catheter site may become life threatening and demands immediate action. Immediately apply pressure to the site. An increased pulse indicates pain and the need for medication, which the nurse should give if other signs of pain are present, but it isn't an emergency intervention. Because a child must remain flat after a cardiac cath, a decrease in urine output may occur, but it doesn't require immediate action unless urine output is absent. An increased body temperature after cardiac catheterization is not abnormal.
A nurse is carting for a child who recently underwent a cardiac catheterization to diagnose a congenital heart defect. Which finding indicates the need for immediate action? A Increased Pulse B Decreased urine output C Increased temperature D Bleeding from the catheter site.
C signs of digoxin toxicity include nausea, vomiting, blurred vision, and yellow-green visual spots, but the mother will only be able to assess objective symptoms such as vomiting. Digoxin causes a decreased heart rate, which can progress to complete heart block if toxicity occurs (digoxin toxicity doesn't lead to tachycardia). Bulging of the anterior fontanel is a sign of increased intracranial pressure.
A nurse is teaching the mother of an infant who will take digoxin (Lanoxin) at home to treat a chronic tachyarrhythmia. Which signs of digoxin toxicity should the mother be taught? A Blurred vision B Heart rate of 180 beats/minute C Vomiting two or more feedings D Bulging of the anterior fontanel
D This murmur is the most characteristic finding in children with VSD
A one month old infant is admitted for confirmation of the diagnosis of ventricular septal defect. During the initial admission assessment, the nurse would expect to find: A Bradycardia at rest B Bounding peripheral pulses C An activity related cyanosis D A murmur at the left sternal border.
A: Status asthmaticus is an acute, prolonged, severe asthma attack that is unresponsive to usual treatment. Typically, the child requires hospitalization.
Alice is rushed to the emergency department during an acute, severe prolonged asthma attack and is unresponsive to usual treatment. The condition is referred to as which of the following? A. Status asthmaticus B. Reactive airway disease C. Intrinsic asthma D. Extrinsic asthma
C Potassium
An 8 year old is admitted with myocarditis and associated tachycardia, and is prescribed fuosemide (Lasix). Which lab value does the nurse need to closely monitor for this child? A Calcium B Glucose C Potassium D Sodium
C: Organizing nursing care to provide for uninterrupted periods of sleep reduces cardiac demand.
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: CF is identified by abnormally thick pulmonary secretions
Betty is a 9-year-old girl diagnosed with cystic fibrosis. Which of the following must Nurse Archie keep in mind when developing a care plan for the child? A. Pulmonary secretions are abnormally thick. B. Elevated levels of potassium are found in sweat. C. CF is an autosomal dominant hereditary disorder. D. Obstruction of the endocrine glands occurs.
B: Absent or diminished femoral pulse is a classic characteristic of coarctation of the aorta.
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: Adequate weight for height demonstrates adequate nutritional intake and lack of edema.
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
D: The blunt, rounded point of the heart is the apex.
It is considered as the bluntly rounded portion of the heart. A. Base B. Pericardium C. Aorta D. Apex
B: The defects associated with tetralogy of Fallot include ventricular septal defect, overriding aorta, pulmonic stenosis (PS), and right ventricular hypertrophy.
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: In the developing fetus, the ductus arteriosus, also called the ductus Botalli, is a blood vessel connecting the pulmonary artery to the proximal descending aorta. It allows most of the blood from the right ventricle to bypass the fetus's fluid-filled non-functioning lungs.
The ductus arteriosus is another fetal structure that is important in the intrauterine life. It functions to: A. Shunts the combined cardiac output from the pulmonary artery to the aorta going to the lungs B. Shunts the combined cardiac output from the pulmonary artery to the systemic circulation C. Shunts the combined cardiac output from the aorta to the pulmonary artery and later to the pulmonary veins D. Shunts the combined cardiac output from the aorta to the pulmonary artery to the right ventricle
D: The Jatene procedure, arterial switch operation, or arterial switch, is an open heart surgical procedure used to correct dextro-transposition of the great arteries (d-TGA).
The procedure that has to be performed in order to shift the high pressure from the right ventricle to the left ventricle in Transposition of the Great Arteries (TGA) is: A. Rashkind Procedure B. Rastelli Procedure C. Pulmonary Artery Banding D. Jatene Procedure
C: PS refers to an obstruction of blood flow from the right 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
D: Tetralogy of Fallot consists of four major anomalies: ventricular septal defect, right ventricular hypertrophy, pulmonic stenosis (PS), aorta overriding the ventricular septal defect. PS impedes the flow of blood to the lungs, causing increased pressure in the right ventricle, forcing deoxygenated blood through the septal defect in the left ventricle. As a result of this decreased pulmonary flow, deoxygenated blood is shunted into the systemic circulation. The increased workload on the right ventricle causes hypertrophy. The overriding aorta receives blood from both the right and left ventricles. This is the definition of defect with decreased pulmonary blood flow where unoxygenated blood is shunted into the systemic circulation.
Which of the following disorders leads to cyanosis from deoxygenated blood entering the systemic arterial circulation? A. Aortic stenosis (AS) B. Coarctation of aorta C. Patent ductus arteriosus (PDA) D. Tetralogy of Fallot
A: The child with congenital heart disease develops polycythemia resulting from an inadequate mechanism to compensate for decreased oxygen saturation.
Which of the following is most likely associated with a cerebrovascular accident (CVA) resulting from congenital heart disease? A. Polycythemia B. Cardiomyopathy C. Endocarditis D. Low blood pressure
C: Extreme bradycardia is a cardinal sign of 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
B, C, and D Option B: The SA node consists of a cluster of cells that are situated in the upper part of the wall of the right atrium (the right upper chamber of the heart). Option C: When action potentials reach the AV node, they spread slowly through it. Option D: Action potentials pass slowly through the atrioventricular node.
Which of these statements regarding the conduction system of the heart is NOT correct? Select all that apply. A. The sinoatrial (SA) node of the heart acts as the pacemaker. B. The SA node is located on the upper wall of the left atrium. C. The AV node conducts action potentials rapidly through it. D. Action potentials are carried slowly through the atrioventricular bundle.
B A calibrated syringe or dropper provides the most accurate measurement of the medication
newborn is diagnosed with coarctation of the aorta. The infant is discharged with a prescription for digoxin (lanoxin) 0.05 mg PO every 12 hours. The bottle of digoxin is labeled 0.15 mg in 1/2 teaspoon, the nurse should teach the mother to administer the medication using a: A Nipple B Calibrated syringe C Plastic measuring spoon D Bottle with an ounce of water
