Peds Success Ch.6 Cardiovascular Disorders
which physiological changes occur as a result of hypoxemia in CHF? a. polycythemia and clubbing b. anemia and barrel chest c. increased white blood cells and low platelets d. elevated erythrocyte sedimentation rate and peripheral edema
a
which client could require feeding by gavage? select all that apply a. infant with CHF b. infant with significant PS c. toddler with repair of transposition of the great vessels d. toddler with KD in the acute phase e. school age child with RF and chorea
a and b
which are the most serious complications for a child with KD? select all that apply a. coronary thrombosis b. coronary stenosis c. coronary artery aneurysm d. hypocoagulability e. decreased sedimentation rate f. hypoplastic left heart syndrome
a, b, c
the Norwood procedure is used to correct: a. transposition of the great vessels b. hypoplastic left heart syndrome c. TOF d. PDA
b
during play, a toddler with a history of TOF might assume which position? a. sitting b. supine c. squatting d. standing
c
what associated manifestation might the nurse occasionally find in a child diagnosed with Wilms tumor? a. atrial fibrillation b. hypertension c. endocarditis d. hyperlipidemia
b
what should the nurse assess before administering digoxin (lanoxin)? a. sclera b. apical pulse rate c. cough d. liver function test
b
in which CHD would the nurse need to take upper and lower extremity BPs? a. transposition of the great vessels b. AS c. COA d. TOF
c
which cardiac murmurs are usually pathologic?
diastolic and continuous murmurs
BP screenings to detect end-organ damage should be done routinely beginning at what age? a. birth b. 3 years c. 8 years d. 13 years
b
aspirin has been ordered for the child with RF in order to: a. keep the PDA open b. reduce joint inflammation c. decrease swelling of strawberry tongue d. treat ventricular hypertrophy of endocarditis
b
a 10 year old had undergone a cardiac catheterization. at the end of the procedure, the nurse should first assess: a. pain b. pulses c. hemoglobin and hematocrit levels d. catheterization report
b
which finding might delay a cardiac catheterization procedure on a 1 year old? a. 30th percentile for weight b. severe diaper rash c. allergy to soy d. oxygen saturation of 91% on room air
b
while looking through the chart of an infant with a CHD of decreased pulmonary blood flow, the nurse would expect which laboratory finding? a. decreased platelet count b. polycythemia c. decreased ferritin level d. shift to the left
b
which drug should not be used to control secondary hypertension in a sexually active adolescent female who uses intermittent birth control? a. beta blockers b. calcium channel blockers c. ACE inhibitors d. diuretics
c
which medication should the nurse give to an infant diagnosed with transposition of the great vessels? a. ibuprofen (motrin) b. betamethasone c. prostaglandin E d. indomethacin (indocin)
c
which plan would be appropriate in helping to control CHF in an infant? a. promoting fluid restriction b. feeding a low salt formula c. feeding semi-fowlers position d. encouraging breast milk
c
a child born with down syndrome should be evaluated for which associated cardiac manifestation? a. CHD b. systemic hypertension c. hyperlipidemia d. cardiomyopathy
a
hypoxic spells in the infant with CHD can cause which of the following? select all that apply a. polycythemia b. blood clots c. CVA d. developmental delays e. viral pericarditis f. brain damage g. alkalosis
a, b, c, d, f
what can an ECG detect? select all that apply a. ischemia b. injury c. CO d. dysrhythmias e. SVR f. occlusion pressure g. conduction delay
a, b, d, g
which is appropriate family discharge teaching following a child's cardiac catheterization? select all that apply a. remove pressure dressing the day after the catheterization b. avoid strenuous exercise for several days c. stay home from school for 1 week d. tub baths may be started tomorrow e. resume the child's normal diet once home
a, b, e
which of the following are examples of acquired heart disease? select all that apply a. infective endocarditis b. hypoplastic left heart syndrome c. RF d. cardiomyopathy e. KD f. transposition of the great vessels
a, c, d, e
which interventions decrease cardiac demands in an infant with CHF? select all that apply a. allow parents to hold and rock their child b. feed only when the infant is crying c. keep the child uncovered to promote low body temperature d. make frequent position changes e. feed the child when sucking on fists f. change bed linens only when necessary g. organize nursing activities
a, d, e, f, g
a child has a glasgow coma scale of 3. HR is 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? a. calcium channel blocker b. beta blocker c. ACE inhibitors d. ARBs
b
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? a. soy b. latex c. penicillin d. dairy
b
treatment for CHF in an infant begins 3 days ago and has included digoxin (lanoxin) and furosemide (lasix). the child no longer has retractions, lungs are clear, and HR is 96 beats per minute while the child sleeps. the nurse is confident that the child has diuresed successfully and has good renal perfusion when the nurse notes the child's urine output is: a. 0.5 cc/kg/hr b. 1 cc/kg/hr c. 30 cc/hr d. 1 oz/hr
b
while assessing a newborn with respiratory distress, the nurse auscultates a machine-like heart murmur. other findings are a wide pulse pressure, periods of apnea, increased PaCO2, and decreased PO2. the nurse suspects that the newborn has: a. pulmonary hypertension b. PDA c. VSD d. bronchopulmonary dysplasia
b
CHDs are classified by which of the following? select all that apply a. cyanotic defect b. acyanotic defect c. defects with increased pulmonary blood flow d. defects with decreased pulmonary blood flow e. mixed defects f. obstructive defects g. pansystolic murmurs
c, d, e, f
PDA causes what type of shunt?
left to right
a 3 month old has been diagnosed with a VSD. the flow of blood through the heart is...
left to right
the flow of blood through the heart with an ASD is...
left to right
a newborn is diagnosed with a CHD. the test results reveal that the lumen of the duct between the sorta and pulmonary artery remains open. this defect is known as...
patent ductus arteriosis (PDA)
indomethacin (indocin) may be given to close which CHD in newborns?
patent ductus arteriosis (PDA)
for a child with hypoplastic left heart syndrome, which drug may be given to allow the PDA to remain open until surgery?
prostaglandin E
a 16 year old being treated for hypertension has a history of asthma. which drug class should be avoided in treating the client's hypertension? a. beta blockers b. calcium channel blockers c. ACE inhibitors d. diuretics
a
the school nurse has been following a child who comes to the office frequently for vague complaints of dizziness and headache. today, she is brought in after fainting in the cafeteria following a nosebleed. her BP is 122/85, and her radial pulses are bounding. the nurse suspects she has: a. transposition of the great vessels b. COA c. AS d. PS
b
a heart transplant may be indicated for a child with severe heart failure and: a. PDA b. VSD c. hypoplastic left heart syndrome d. PS
c
family discharge teaching has been effective when the parent of a toddle diagnosed with KD states: a. "the arthritis in her knees is permanent. she will need knee replacements." b. "I will give her diphenhydramine (benadryl) for her peeling palms and soles of her feet." c. "I know she will be irritable for 2 months after her symptoms started." d. "I will continue with high doses of tylenol for her inflammation."
c
the most common cardiac dysrhythmia in the pediatric population is: a. ventricular tachycardia b. sinus bradycardia c. supraventricular tachycardia d. first degree heart block
c
which assessments indicate that the parent of a 7 year old is following the prescribed treatment for CHF? select all that apply a. HR of 56 beats per minute b. elevated red blood cell count c. 50th percentile height and weight for age d. urine output of 0.5 cc/kg/hr e. playing basketball with other children his age
c and e
which statement by the mother of a child with RF shows she has good understanding of the care of her child? select all that apply a. "I will apply heat to his swollen joints to promote circulation" b. "I will have him do gentle stretching exercises to prevent contractures" c. "I will give him his ordered anti-inflammatory medication for pain and inflammation" d. "I will apply cold packs to his swollen joints to reduce pain" e. "I will take my child every month to the healthcare provider's office for his penicillin shot"
c and e
during a well child checkup for an infant with TOF, the child develops severe respiratory distress and becomes cyanotic. the nurse's first action should be to: a. lay the child flat to promote hemostasis b. lay the child flat with legs elevated to increase blood flow to the heart c. sit the child on the person's lap, with legs dangling, to promote venous pooling d. hold the child in knee-chest position to decrease venous blood return
d
which procedures require preventive antibiotics for children with high risk cardiac disease?
dental, invasive, and infected skin
the mother of a toddler reports that the child's father has just had an MI. because of this information, the nurse recommends the child have a(n): a. ECG b. lipid profile c. echocardiogram d. cardiac catheterization
b
a child diagnosed with CHF is receiving maintenance doses of digoxin (lanoxin) and furosemide (lasix). 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? a. hypokalemia b. hypomagnesemia c. hypocalcemia d. hypophosphatemia
a
a nursing action that promotes ideal nutrition in an infant with CHF is: a. feeding formula that is supplemented with additional calories b. allowing the infant to nurse at each breast for 20 minutes c. providing large feedings every 5 hours d. using firm nipples with small openings to slow feedings
a
exposure to which illness should be a cause to discontinue therapy and substitute dipyridamole (persantine) in a child receiving aspirin therapy for KD? a. chickenpox or influenza b. E.coli or staphylococcus c. candida or streptococcus A d. streptococcus A or staphylococcus
a
the nurse is caring for a child with KD. a student nurse who is on the unit asks if there are medications to treat this disease. the nurse's response to the student nurse is: a. immunoglobulin G and aspirin b. immunoglobulin G and ACE inhibitors c. immunoglobulin E and heparin d. immunoglobulin E and ibuprofen (motrin)
a
an adolescent has been diagnosed with hyperlipidemia on a screening laboratory test. which of the following would the nurse recommend to decrease his hyperlipidemia? select all that apply a. heart healthy diet b. lipid lowering medication c. repeat screening laboratory test in 2 weeks d. consume sports drinks during practice and games e. lifestyle modifications
a and e
TOF involves which defects? select all that apply a. VSD b. right ventricular hypertrophy c. left ventricular hypertrophy d. PS e. pulmonic atresia f. overriding aorta g. PDA
a, b, d, f
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: a. VSD b. AS c. mitral valve prolapse d. tricuspid atresia
b
the nurse is caring for an 8 year old girl whose parents indicate she has developed spastic movements of her extremities and trunk, facial grimace, and speech disturbances. they state it seems worse when she is anxious and does not occur while sleeping. the nurse questions the parents about which recent illness? a. KD b. RF c. malignant hypertension d. atrial fibrillation
b
the parents of a 3 month old ask why their baby will not have an operation to correct a VSD. the nurse's best response is: a. "it is always helpful to get a second opinion about any serious conditions like this." b. "your baby's defect is small and will likely close on its own by 1 year of age." c. "it is common for healthcare providers to wait until an infant develops respiratory distress before they do the surgery." d. "with a small defect like this, they wait until the child is 10 years old to do the surgery."
b
on examination, a nurse hears a murmur at the LSB in a child with diarrhea and fever. the parent asks why the healthcare provider never mentioned the murmur. the nurse explains: a. "the healthcare provider is not a cardiologist" b. "murmurs are difficult to detect, especially in children" c. "the fever increased the intensity of the murmur" d. "we need to refer the child to an interventional radiologist"
c
which statement by the mother of a child with RF shows an understanding of prevention for her other children? a. "whenever one of them gets a sore throat, I will give that child an antibiotic." b. "there is no treatment. it must run its course." c. "if their culture is positive for group A streptococcus, I will give them their antibiotic." d. "if their culture is positive for staphylococcus A, I will give them their antibiotic."
c
the nurse is caring for a 9 month old who was born with a CHD. assessment reveals a HR of 160, capillary reveal of 4 seconds, bilateral crackles, and sweat on the scalp. these are signs of...
congestive heart failure (CHF)
the ___________ serves as the septal opening between the atria of the fetal heart.
foramen ovale
a child has been diagnosed with valvular disease following RF. during patient teaching the nurse discusses the child's longterm prophylactic therapy with antibiotics for dental procedures, surgery, and childbirth. the parents indicate they understand when they say: a. "she will need to take the antibiotics when she has such procedures until she is 18 yeas old." b. "she will need to take the antibiotics when she has such procedures for 5 years after the last attack." c. "she will need to take the antibiotics when she has such procedures for 10 years after the last attack." d. "she will need to take the antibiotics when she has such procedures for the rest of her life."
d
a toddler who has been hospitalized for vomiting because of 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? a. rapid pulmonary flutter b. sinus bradycardia c. rapid atrial fibrillation d. supraventricular tachycardia
d
the nurse is caring for a child who has undergone a cardiac catheterization. during recovery, the nurse notices the dressing is saturated with bright red blood. the nurse's first action is to... a. call the interventional cardiologist b. notify the cardiac catheterization laboratory that the child will be returning c. apply a bulky pressure dressing over the present dressing d. apply direct pressure 1 inch above the puncture site
d
which statement by a parent of an infant with CHF who is being sent home on digoxin (lanoxin) indicates the need for further education? a. "I will give the medication at regular 12 hour intervals" b. "if he vomits, I will not give a make up dose" c. "if I miss a dose, I will not give an extra dose" d. "I will mix the digoxin in some formula to make it taste better"
d
which vaccines must be delayed for 11 months after the administration of gamma globulin? select all that apply a. diphtheria, tetanus, and pertussis b. hepatitis B c. inactivated polio virus d. measles, mumps, and rubella e. varicella
d and e
a child who has reddened eyes with no discharge; red, swollen, and peeling palms and soles of feet; dry, cracked lips, and a strawberry tongue most likely has:
kawasaki disease (KD)
a 10 year old child is recovering from a severe sore throat. the parent states that the child complains of chest pain. the nurse observes that the child has swollen joints, nodules on the fingers, and a rash on the chest. the likely cause is...
rheumatic fever (RF)
a 6 month old who has episodes of cyanosis after crying could have the CHD of decreased pulmonary blood flow called...
tetralogy of fallot (TOF)