Chapter 26: The Child with a Cardiovascular Disorder

Which comment made by a parent of a 1-month-old would alert the nurse about the presence of a congenital heart defect?

"He tires out during feedings."

The nurse explained how to position an infant with tetralogy of Fallot if the infant suddenly becomes cyanotic. Which statement by the father leads the nurse to determine he understood the instructions?

"If the baby turns blue, I will hold him against my shoulder with his knees bent up toward his chest."

Which assessment would lead the nurse to suspect that a newborn infant has a ventricular septal defect?

A loud, harsh murmur with a systolic thrill

What does the nurse explain that a ventricular septal defect will allow?

Blood to shunt left to right, causing increased pulmonary flow and no cyanosis

How long should a 4-year-old child recovering from rheumatic fever need to receive monthly injections of penicillin G?

5 years

What should the school nurse recommend when encouraging a heart-healthy diet for a child with high cholesterol?

A fat intake reduction of 25-35% of total calories

Through what does the infant born with hypoplastic left heart syndrome acquire oxygenated blood?

An atrial septal defect

Which congenital cardiac defect(s) cause(s) increased pulmonary blood flow? (Select all that apply.)

Atrial septal defects (ASDs) Patent ductus arteriosus Ventricular septal defects (VSDs)

An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). What does the nurse understand regarding why dyspnea occurs?

Blood is circulated through the lungs again, causing pulmonary circulatory congestion

What finding would the nurse expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta?

Blood pressure is lower in the legs than in the arms

The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, "Why do my child's fingertips look like that?" On what understanding does the nurse base a response?

Clubbing occurs as a result of chronic hypoxia.

A pediatric patient is scheduled for a noninvasive procedure to determine if his heart is structurally normal and to localize a murmur. What diagnostic test does the nurse anticipate?

Echocardiogram

How would the nurse caring for an infant with congestive heart failure (CHF) modify feeding techniques to adapt for the child's weakness and fatigue? (Select all that apply.)

Feeding more frequently with smaller feedings Using a soft nipple with enlarged holes Holding and cuddling the child during feeding Offering high-caloric formula

________________________is designed to serve the metabolic needs during intrauterine life and also to permit safe transition to life outside the womb.

Fetal circulation

A child develops carditis from rheumatic fever. Which areas of the heart are affected by carditis?

Heart muscle and the mitral valve

Systemic blood pressure increases with age and is correlated with _________ and _________throughout childhood and adolescence.

Height; weight

A 16-year-old patient is diagnosed with primary hypertension. What risk factors does the nurse mention when providing education on this diagnosis to the patient and his family? (Select all that apply.)

Heredity Stress Obesity Poor diet

What are the four structural heart anomalies that make up the tetralogy of Fallot? (Select the four that apply.)

Hypertrophied right ventricle Patent ductus arteriosus Narrowing of pulmonary artery Dextroposition of aorta

The nurse is caring for a child with a diagnosis of Kawasaki disease. The child's parents ask the nurse, "How does Kawasaki disease affect my child's heart and blood vessels?" On what understanding is the nurse's response based?

Inflammation weakens blood vessels, leading aneurysm.

Because the diagnosis of rheumatic fever is difficult, an aid used to identify the presence of rheumatic fever is the _____________ _______________.

Jones criteria

A child has an elevated antistreptolysin O (ASO) titer. Which combination of symptoms, in conjunction with this finding, would confirm a diagnosis of rheumatic fever?

Painful, tender joints and carditis

The nurse is planning a hypertension-prevention program. What should be the main focus of the nurse when presenting information?

Patient education

_______________ is a systemic disease involving the joints, heart, central nervous system (CNS), skin, and subcutaneous tissues. It belongs to a group of disorders known as collagen diseases.

Rheumatic fever (RF)

What assessment(s) in a child with tetralogy of Fallot would indicate the child is experiencing a paroxysmal hypercyanotic episode? (Select all that apply.)

Spontaneous cyanosis Dyspnea Weakness Syncope

A father asks why his child with tetralogy of Fallot seems to favor a squatting position. What is the nurse's best response?

Squatting increases the return of venous blood back to the heart.

A child with rheumatic fever begins involuntary, purposeless movements of her limbs. What does the nurse recognize that this indicates?

Sydenham's chorea

What is accurate about the characteristics of high-density lipoproteins (HDLs)?

They have little cholosterol

An infant with congestive heart failure is receiving digoxin (Lanoxin). What does the nurse recognize as a sign of digoxin toxicity?

Vomiting

Which is the most appropriate nursing action related to the administration of digoxin (Lanoxin) to an infant?

Withholding a dose if the apical heart rate is less than 100 beats/min.

The nurse explains that the difference between the systolic blood pressure reading and the diastolic blood pressure reading is called the __________ ___________.

pulse pressure

The nurse takes into consideration that the most common congenital heart defect is the ____________ ____________ defect

ventricular septal