Ch 17 Cardiovascular Conditions in Children
Symptoms of the congenital heart defect seen in the figure include a possible systolic murmur, right ventricular thrill, and left-to right shunting due to the defect. Which congenital heart defect is pictured? Patent ductus arteriosus Patent foramen ovale Atrial septal defect Ventricular septal defect
CORRECT: Atrial septal defect
A nurse caring for an infant diagnosed with coarctation of the aorta (CoA) would expect to see which of the following on assessment? Blood pressure in the arms is greater than 10 mm Hg higher than blood pressure in the legs Blood pressure is higher in the left arm than the right arm Diastolic ejection murmur Systemic hypotension
CORRECT: Blood pressure in the arms is greater than 10 mm Hg higher than blood pressure in the legs
When learning about cyanotic heart defects, the student nurse understands which of the following are true? Select all that apply. Blood shunts left to right. Oxygen saturations levels are typically 96%-100%. Long-term low oxygenation results in polycythemia. It causes an increased risk of thrombi and stroke. Obstructive heart lesions cause acyanotic defects.
CORRECT: Long-term low oxygenation results in polycythemia. It causes an increased risk of thrombi and stroke.
A nurse is caring for a 3-year-old patient immediately post-op open heart surgery to correct a severe congenital heart defect. Which lab value should the nurse be most concerned with after surgery? Potassium is 5.1 mmol/L Hemoglobin is 10 g/dL Hematocrit is 33% Sodium is 135 mmol/L
CORRECT: Potassium is 5.1 mmol/L
A 39-week pregnant woman is being induced. During regular prenatal care, the fetus was diagnosed with tricuspid atresia. Upon birth, the newborn will be admitted to the neonatal intensive care nursery. The nurse admitting the newborn can expect what immediate initial treatment? Open heart surgery Fontan procedure Prostaglandin administration Indomethacin administration
CORRECT: Prostaglandin administration
At a 4-month well-child check, a caregiver expresses concern that the child is much smaller than their other child was at the same age. The caregiver also states the child seems to tire easily when breastfeeding and "doesn't seem to take a whole feeding." What other signs and symptoms would indicate concern for a ventricular septal defect (VSD)? Select all that apply. Puffy eyes Sweating when breastfeeding Frequent respiratory infections Diarrhea Vomiting after feedings
CORRECT: Puffy eyes Sweating when breastfeeding Frequent respiratory infections
A 14-year-old presents to the ER with a circular red rash with raised edges on their trunk. Upon taking a history, it is noted the child was diagnosed with strep pharyngitis 2 weeks ago. A diagnosis of rheumatic fever is likely. Which signs and symptoms support this diagnosis? Select all that apply. Recent tick bite Sydenham's chorea Prolonged QR interval Emotional outbursts Murmur over the mitral valve area.
CORRECT: Sydenham's chorea Emotional outbursts Murmur over the mitral valve area.
When teaching a group of new nurses about acyanotic heart defects, which statement is true? These defects prevent flow through the systemic circulation. These defects cause left-to-right shunting. Young pediatric patients with acyanotic defects experience respiratory distress with feeding. Acyanotic defects are patent ductus arteriosus (PDA)-dependent.
CORRECT: These defects cause left-to-right shunting.
A child is being evaluated after a fainting episode while the parent was brushing their hair. Seizure disorder and Long QT syndrome have been ruled out as diagnoses. Knowing that the child fainting episode was due to neurally mediated syncope (NMS), what definitive diagnostic test does the nurse prepare the child for? ECG Cardiac catheterization Tilt test Orthostatic blood pressure
CORRECT: Tilt test
In a normal heart of a pediatric patient, what is most responsible for the 'pumping' work of the heart? Atria Ventricles Vessels Valves
CORRECT: Ventricles
A nurse caring for an infant with early stages of right heart failure due to a congenital heart defect expects to find which of the following on assessment? Select all that apply. Ascites Bulging fontanelles Edema in hands and feet Hyperactivity Poor feeding
CORRECT: Bulging fontanelles Edema in hands and feet Poor feeding
A nursing instructor teaching a group of nursing students during a neonatal intensive care unit clinical knows further instruction is needed based on which statement about a patent ductus arteriosus (PDA)? Select all that apply. "It causes left-to-right shunting." "It occurs when the vessel that normally connects the aorta and pulmonary artery in utero does not close after birth." "A PDA leads to left ventricular hypertrophy." "A child with a PDA will have a narrow pulse pressure." "Prostaglandins assist with closure of a PDA."
CORRECT: "A PDA leads to left ventricular hypertrophy." "A child with a PDA will have a narrow pulse pressure." "Prostaglandins assist with closure of a PDA."
A student nurse learning about ventricular septal defects (VSD) correctly understands the defect when they state which of the following? "There is an increase in pulmonary blood flow due to blood being shunted to the right ventricle bypassing the left ventricle." "There is a decrease in pulmonary blood flow due to blood being shunted to the right ventricle bypassing the left ventricle." "There is an increase in pulmonary blood flow as a result of the blood shunting from the left to the right ventricle." "There is a decrease in pulmonary blood flow as a result of the blood shunting from the left to the right ventricle."
CORRECT: "There is an increase in pulmonary blood flow as a result of the blood shunting from the left to the right ventricle."
A nurse is providing discharge teaching to parents of a 9-month-old infant that just had open-heart surgery to correct a congenital heart defect. The infant will be discharged home on nasal cannula oxygen supplementation. What should the nurse include in the discharge teaching? Select all that apply.
CORRECT: "You must only cradle the infant when picking up or carrying them" "only use sponge-baths until surgical site is healed"
A nursing instructor knows the student nurse needs further instruction when they state which of the following are associated with Tetralogy of Fallot (TOF)? Select all that apply. Aortic stenosis Left ventricular hypertrophy Ventral Septal Defect Overriding aorta Pulmonary stenosis
CORRECT: Aortic stenosis Left ventricular hypertrophy