OB/PEDS (Workbook) 40 & 41

_________ refers to an enlargement of the heart caused by hypertrophy or thickening of the walls of the heart.

hypertrophic cardiomyopathy

Pulse oximetry is an indirect measurement of oxygen saturation in arterial blood

indirect

The nurse knows that respiratory disorders in children are sometimes attributed to anatomical and physiological differences from adults. Which statement is accurate

infants consume twice as much oxygen as adults

________________ retractions are seen as an inward pulling between the ribs.

intercostal

A nurse is assessing the skin of a 12-year-old with suspected right ventricular heart failure. Where should the nurse expect to note edema in this child?

lower extremities

Tuberculin skin testing is also known as

mantox test

The nurse is assessing several children. Which child is most at risk for dysphagia

5-year-old with epiglottis

Most cases of heart failure in children with congenital heart defects occur by the age of

6 months

The young child is wearing a nasal cannula. The oxygen is set at 3 L/min. Calculate the percentage of oxygen the child is receiving. Record your answer suing a whole number

33

The nurse is assessing the past medical history of an infant with a suspected cardiovascular disorder. Which response by the mother warrants further investigation

"I am on a low dose of steroids"

The nurse is auscultating the lungs of a lethargic, irritable 6-year-old boy and hears wheezing. The nurse will most likely include which teaching point if the child is suspected of having asthma

"I'm going to have this hospital worker take a picture of your lungs"

The maximum recommended oxygen flow for the nasal cannula in children is _____ L/min.

4

The nurse is discussing the differences between children's and adult's respiratory systems. Which statements by the nurse are accurate? Select all that apply

"The only time that newborns can breathe through their mouths is when they cry" "A newborn's respiratory tract is drier because the newborn doesn't make very much mucus"

________________ is an acute, systemic vasculitis occurring mostly in infants and young children.

Kawasaki disease

______ relax the smooth airway muscles resulting in bronchodilation.

Short-acting beta 2-adrenergic agonists

The young child had a chest tube placed during cardiac surgery. Which findings may indicate the development of cardiac tamponade?

The chest tube drainage had been averaging 15-25 mL out per hour and now there is no drainage from the chest tube

The nurse is conducting a physical examination of an infant with a suspected cardiovascular disorder. Which assessment finding is suggestive of sudden ventricular distention

accentuated third heart sound

management of hypertension

ace inhibitors

Cardiac disorders that are not congenital are considered _______ disorders

acquired

Depending on ______ differ from those of adults.

age, the structure and function of the infant's and child's cardiovascular system

The child has been diagnosed with asthma and the child's physician is using a stepwise approach. Rank the following in the order the nurse should administer these medications as the child's condition worsens

albuterol as needed low-dose inhaled corticosteroids medium-dose inhaled corticosteroids medium-dose inhaled corticosteroids and salmeterol

temporary maintenance of ductus arteriosus patency in infants with ductal-dependent congenital heart defects

alprostadil

Rales are crackling sounds, heard during auscultation, that are the result of the _______

alveoli becoming filled with fluid

Cardiac __________ is the radiographic study of the heart and coronary vessels after injection of contrast medium

angiography

Pseudoephedrine is an example of a ________ used for the treatment of runny or stuffy nose associated with the common cold

decongestant

Alveolar collapse or loss of lung volume, referred to as ____________, can cause grunting on expiration.

atelectasis

Allergic rhinitis is associated with ______ dermatitis and asthma

atopic

Most children with _________ are asymptomatic.

atrial septal defects

_____ a child before and after cardiac surgery may boost the infant's immune system.

breastfeeding

The _____________________ normally closes shortly after birth but may remain open in some children with congenital heart disease.

ductus arteriosus

Cardiac catheterization may be categorized as diagnostic, interventional, or

electrophysiologic

The nurse is developing a teaching plan for the parents of a 10-year-old boy with cystic fibrosis. The plan should include teaching about the use of a

flutter valve device

Tetralogy of Fallot is a congenital heart defect that refers to a combination of ___________ heart defects occurring together.

four

management of edema associated with heart failure

furosemide

A ______ murmur is soft and hard to hear.

grade I

It is a ______ murmur that is loud but does not have a thrill associated with it.

grade III

prophylaxis and treatment of thromboembolic disorders especially after cardiac surgery

heparin

The nurse is caring for a 3-year-old girl who is cyanotic and breathing rapidly. Which intervention is best to relieve these symptoms?

oxygen administration

Which findings are major criteria used to help the physician diagnose acute rheumatic fever in a child?

painless nodules located on the wrists pericarditis with the presence of a new heart murmur

oxygen reservoir bag

partial rebreather mask

Examples of defects with increased _______ blood flow are patent ductus arteriosus (PDA), atrial septal defect (ASD), and ventricular septal defect (VSD)

pulmonary

A sign of respiratory distress, ________________ may be observed on inhalation.

retractions

_______ is a delayed disorder resulting from group A streptococcal pharyngeal infection

rheumatic fever

minimum flow rate of 6 L/min

simple face mask

The nurse is caring for an 8-month-old infant with suspected congenital heart defect. The nurse examines the child and documents which expected finding?

softening of the nail beds

_____ is a high-pitched, readily audible inspiratory noise and is a sign of upper airway obstruction.

stridor

_____ is an important intervention for an infant with a common cold.

suctioning

The S3 heart sound may be heard in children, diminishing when moving from

supine to upright

Often the first sign of respiratory illness in infants and children is _______.

tachypnea

The nurse is taking a health history for a 3-year-old girl suspected of having pneumonia who presents with a fever, chest pain, and cough. Which information places the child at risk for pneumonia

the child attends daycare

A ________ is a surgical construction of a respiratory opening in the trachea

tracheostomy

The nurse is caring for a 10-year-old girl with allergic rhinitis. Which intervention helps prevent secondary bacterial infection

using normal saline nasal washes

mixes room air and oxygen

venturi mask

The infant has been hospitalized and develops hypercyanosis. The physician has ordered the nurse to administer 0.1 mg of morphine sulfate per every kilogram of the infant's body weight. The infant weighs 15.2 lb (6.81 kg). Calculate the infant's morphine sulfate dose. Record your answer using one decimal place

0.7

place the changes the occur in the cardiopulmonary system immediately following birth

1. lungs inflate 2. reduction of pulmonary vascular resistance to blood flow 3. drop in pulmonary artery pressure 4. decreased pressure in the right atrium 5. closure of the foramen ovale 6. closure of the ductus arteriosus

The young child has been diagnosed with group A streptococcal pharyngitis. The physician orders amoxicillin 45 mg/kg in three equally divided doses. The child weighs 23 lb (10.45 kg). Calculate how many milligrams the child will receive with each dose of amoxicillin. Record our answer using a whole number

157

The pediatric nurse has digoxin ordered for each of five children. The nurse should withhold digoxin for which children?

16-year-old with a heart rate of 54 bpm 2-year-old child whose digoxin level was 2.4 ng/mL from a blood draw this morning 5-year-old who developed vomiting and diarrhea, and is difficult to arouse

The nurse is assessing the heart rate of a healthy 6-month-old. In which range should the nurse expect the infant's heart rate

90 to 160 bpm

______ is the enlargement of the terminal phalanx of the fingers resulting from chronic hypoxemia.

Clubbing

The nurse performs a cardiac assessment and notes a loud heart murmur with a precordial thrill. This murmur would be classified as a

Grade IV

_________ is an abnormal enlargement of the distal phalanges usually associated with cyanotic heart disease or advanced chronic pulmonary disease.

clubbing

A femoral pulse that is weak or absent in comparison to the brachial pulse is associated with ________ of the aorta.

coarctation

The child has returned to the nurse's unit following a cardiac catheterization. The insertion site is located at the right groin. Peripheral pulses were easily palpated in bilateral lower extremities prior to the procedure. Which finding should be reported to the child's physician

The child's right foot is cool with a pulse assessed only with the use of a Doppler The child has a temperature of 102.4 F The child is reporting nausea

The child has been admitted to the hospital with a possible diagnosis of pneumonia. Which findings are consistent with this diagnosis. Select all that apply

The child's x-ray indicates the presence of perihilar infiltrates The child's white blood cell count is elevated The child's respiratory rate is rapid The child is producing yellow purulent sputum

A nurse is palpating the pulse of a child with suspected aortic regurgitation. Which assessment finding should the nurse expect to note

bounding pulse

Hypoventilation occurs secondary to markedly _____________ work of breathing.

increased

The nurse is conducting a physical examination of a 7-year-old girl prior to a cardiac catheterization. The nurse knows to pay particular attention to assessing the child's pedal pulses. How can the nurse best facilitate their assessment after the procedure?

mark the child's pedal pulses with an indelible marker, then document

The nurse is auscultating the heart sounds of a child with a mitral valve prolapse. The nurse should expect which assessment finding

mild to late ejection click at the apex

Coarctation of the aorta is defined as _________ of the aorta

narrowing

must have patent nasal passages

nasal cannula

medication to lower blood cholesterol level

niacin

one-way valve

non-rebreather

95% oxygen may be delivered with a _____, when set at 10 to 12 L/min.

non-rebreather mask

Usually a thin watery nasal discharge, ____________ is commonly called runny nose.

rhinorrhea

Edema of the lower extremities is characteristic of _______ ventricular heart failure in older children.

right

In children ___ is the best indicator of changes in fluid status.

weight

Auscultation of the lungs might reveal _______ or rales in the younger child with pneumonia

wheezes

The nurse is caring for a 14-month-old boy with cystic fibrosis. Which sign of ineffective family coping requires urgent intervention?

compliance with therapy is diminished

Cough and _______ are symptoms of influenza for both children and adults

coryza

Seen as a blue or gray coloration of the skin, ____________ is a sign of poor oxygenation.

cyanosis