Pedi Cardiac Ch. 19

Parents are told their infant has a hypoplastic left heart. How would the nurse explain this condition to the family?

This is a problem where the left side of the heart did not develop properly.

A parent is asking for more information about their infant's patent ductus arteriosus (PDA). What would be included in the education?

This is caused by an opening that usually closes by 1 week of age.

In caring for the child with rheumatic fever, which medication would the nurse likely administer?

Tylenol

After assessing a child, the nurse suspects coarctation of the aorta based on a finding of:

femoral pulse weaker than brachial pulse.

The nurse is caring for a child with heart failure related to a congenital heart defect. One of the nursing diagnoses identified includes "Excess fluid volume." During a family care planning conference. the parents ask why this diagnosis applies to their child. What is the best response by the nurse?

• "Cardiac problems cause the heart to not pump effectively, which causes swelling in the body and fluid in the lungs."

The nurse is assessing a child with suspected rheumatic fever. What findings would the nurse expect to assess? Select all that apply.

• Involuntary limb movement • Macular rash on trunk • Tender swollen joints

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

Softening of the nail beds

A parent asks if the reason her infant has a congenital heart defect is because of something she did while she was pregnant. What is the best response by the nurse?

There are several reasons a baby can have a heart defect, let's talk about those causes.

An infant with tetralogy of Fallot becomes cyanotic. Which nursing intervention would be the first priority?

Place the infant in the knee-chest position.

When reviewing the record of a child with tetralogy of Fallot, what would the nurse expect to discover?

Polycythemia

A parent brings an infant in for poor feeding. Which assessment data would most likely indicate a coarctation of the aorta?

Pulses weaker in lower extremities compared to upper extremities

A newborn has been diagnosed with a congenital heart disease. Which congenital heart disease is associated with cyanosis?

Tetralogy of Fallot

The nurse is reviewing nutritional recommendations with the parents of a teen diagnosed with hyperlipidemia. Which statements indicate an understanding of the recommended diet for this condition? Select all that apply.

• "I should plan to have vegetables with each evening meal served." • "Adding fresh fruits to my child's lunch is a good idea." • "My child loves chicken and I can still serve it but I need to remove the skin."

The nurse is caring for a 7-year-old who is being discharged following surgery with a Gore® Helex device to repair an atrial septal defect. The parents of the child demonstrate understanding of the procedure with which statements? Select all that apply.

• "We will be sure to not allow our child to ride a bicycle for at least 2 weeks." • "We will be sure to monitor our child for any signs of infection and notify the doctor if we notice any." • "We know how important our child's medications are so we will write out a schedule to be sure medications are taken as prescribed."

A nurse is taking the history of a 4-year-old boy who will undergo a cardiac catheterization. Which statement by his mother may necessitate rescheduling of the procedure?

"He seems listless and slightly warm."

The parents of a 5-year-old child with a cardiovascular disorder tell the nurse they don't understand why their child isn't gaining weight, "We make sure our child has 3 very nutritious meals every day." How should the nurse respond?

"It's great you are providing nutritious meals, but smaller frequent meals will tire your child less and promote weight gain."

A child will be undergoing a Holter monitor test. Which statement by the mother indicates the need for further instruction?

"My child cannot have any thing to eat or drink after midnight the day of the test."

The nurse is providing child and family education prior to discharge following a cardiac catheterization. The nurse is teaching about signs and symptoms of complications. Which statement by the mother indicates a need for further teaching?

"The feeling of the heart skipping a beat is common."

A nurse is teaching the parents of a child diagnosed with rheumatic fever about prescribed drug therapy. Which statement would indicate to the nurse that additional teaching is needed?

"We can stop the penicillin when her symptoms disappear."

The nurse is caring for an infant with Down syndrome who has been diagnosed with atrioventricular canal defect. The parents ask the nurse, "Why do you not put oxygen on our baby more often when his lips and fingernails are blue?" What is the best response by the the nurse?

"While it seems that oxygen would help, it actually worsens this condition. Treating the cause of the disease will help."

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

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

The nurse is performing echocardiography on a newborn who is suspected of having a congenital heart defect. The child's mother is concerned about the safety of using this on a newborn and wants to know how this technology works. The nurse assures her that this technology is very safe and may be repeated frequently without added risk. What should the nurse mention in explaining how this diagnostic test works?

High-frequency sound waves are directed toward the heart

A nurse is reviewing blood work for a child with a cyanotic heart defect. What result would most likely be seen in a client experiencing polycythemia?

Increased RBC

A 6-year-old girl is diagnosed with pulmonary stenosis. The mother asks the nurse what the likely treatment for this condition will involve. What should the nurse tell the mother?

Insertion of a catheter with an uninflated balloon tip into the affected valve, followed by inflation of the balloon to break up adhesions

An infant with poor feeding is suspected of having a congenital heart defect. The parents are asking why a chest x-ray is necessary in their infant. What is the best response from the nurse?

It will determine if the heart is enlarged.

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

A nurse is administering digoxin to a 3-year-old. What would be a reason to hold the dose of digoxin?

Nausea and vomiting

A nurse suspects a child is experiencing cardiac tamponade after heart surgery. What would be the priority nursing intervention?

Notify the doctor immediately.

The nurse is caring for a 6-year-old child with a congenital heart defect. To best relieve a hypercyanotic spell, what action would be the priority?

Place the child in a knee-to-chest position.

A child with heart disease is receiving digoxin and a diuretic. Which laboratory test result would be most important for the nurse to monitor?

Serum potassium level

A nursing instructor is preparing for a class about the structural and functional differences in the cardiovascular system of infants and children as compared to adults. What would the instructor include in the class discussion?

The heart's apex is higher in the chest in children younger than the age of 7 years.

When examining a child with congenital heart disease, an organ in the upper right quadrant of the abdomen can be palpated at 4 cm below the rib cage. What would most likely explain this assessment finding?

The liver size increases in right-sided heart failure.

A nurse is interviewing a mother who is about to deliver her baby. Which response would alert the nurse for a higher potential for a heart defect in the infant?

The mother states she has lupus.