Peds cardiovascular

C. Because closure of the pulmonary valve is delayed in ASD, a split S2 is produced.

When auscultating the heart of a patient with an atrial septal defect (ASD), the healthcare provider hears a split S2. What is the significance of this heart sound? A. When the ventricles fill rapidly the split S2 is produced B. The split S2 is produced when the mitral valve opens with a snap. C. Because closure of the pulmonary valve is delayed in ASD, a split S2 is produced. D. The S2 is normally split so this is not a significant finding

C. Obstruction of blood flow from the right ventricle

When creating a teaching program for the parents of Jessica who is diagnosed with pulmonic stenosis (PS), Nurse Alex would keep in mind that this disorder involves which of the following? A. A single vessel arising from both ventricles B. Obstruction of blood flow from the left ventricle C. Obstruction of blood flow from the right ventricle D. Return of blood to the heart without entry to the left atrium

D. Tetralogy of Fallot

Which of the following disorders leads to cyanosis from deoxygenated blood entering the systemic arterial circulation? A. Aortic stenosis (AS) B. Coarctation of aorta C. Patent ductus arteriosus (PDA) D. Tetralogy of Fallot

A. Treating streptococcal throat infections with an antibiotic

Which of the following instructions would Nurse Courtney include in a teaching plan that focuses on initial prevention for Sheri who is diagnosed with rheumatic fever? A. Treating streptococcal throat infections with an antibiotic B. Giving penicillin to patients with rheumatic fever C. Using corticosteroid to reduce inflammation D. Providing an antibiotic before dental work

C. Extreme bradycardia

Which of the following would Nurse Tony suppose to regard as a cardinal manifestation or symptom of digoxin toxicity to his patient Clay diagnosed with heart failure? A. Headache B. Respiratory distress C. Extreme bradycardia D. Constipation

B,C,D

Which of these statements regarding the conduction system of the heart is NOT correct? Select all that apply. A. The sinoatrial (SA) node of the heart acts as the pacemaker. B. The SA node is located on the upper wall of the left atrium. C. The AV node conducts action potentials rapidly through it. D. Action potentials are carried slowly through the atrioventricular bundle.

C

A nurse is providing teaching to a mother of an infant who is to start taking digoxin (Lanoxin). Which of the following instructions should the nurse include? A. "Do not offer your baby fluids after giving the medication." B. "Digoxin increases your baby's heart rate." C. "Give the correct dose of medication at regularly scheduled times." D. "If your baby vomits a dose, you should repeat the dose to ensure that he gets the correct amount."

Tricuspid atresia, Hypoplastic left heart syndrome

2 disorders that need a 3 stage surgery

Norwood procedure Glenn shunt Fontan procedure

3 stages of heart surgery

pulmonary stenosis, ventricular septal defect, overriding aorta,right ventricular hypertrophy

4 defects of tetralogy of ballot

A. Potassium 3.2 mEq/L

A 5 year-old child with a congenital heart defect is to receive digoxin PO. Prior to administration, the healthcare provider checks the most recent laboratory report. Which laboratory value should be of most concern to the healthcare provider? A. Potassium 3.2 mEq/L B. Digoxin level 0.8ng/mL C. Hemoglobin 10g/dL D. Creatinine 0.4 mg/dL

D. Aneurysm formation

A 5-year-old girl Hannah is recently diagnosed with Kawasaki disease. Apart from the identified symptoms of the disease, she may also likely develop which of the following? A. Sepsis B. Meningitis C. Mitral valve disease D. Aneurysm formation

Tricuspid atresia

A complete closure of the tricuspid valve that results in mixed blood flow. An atrial septal opening needs to be present to allow blood to enter left atrium

Transposition of the great arteries

A condition in which the aorta is connected to the right ventricle instead of the left and the pulmonary artery is connected to the left ventricle instead of the right. A septal defect or a PDA must exist in order to oxygenate the blood

Patent ductus arteriosus

A condition in which the normal fetal circulation conduit between the pulmonary artery and aorta fails to close and results in increased pulmonary blood flow -wide pulse pressure -asymptomatic

Atrial septal defect (ASD)

A hole in the septum between the right and left atria that results in increased pulmonary blood flow -loud, harsh murmur with a fixe split second sound

Ventricular septal defect (VSD)

A hole in the septum between the right and left ventricle that results in increased pulmonary blood flow -many close spontaneously

B,C,E

A nurse is assessing an infant. Which of the following should the nurse recognize as clinical manifestations of heart failure? (Select all that apply.) A. Bradycardia B. Cool extremities C. Peripheral edema D. Increased urinary output E. Nasal flaring

B

A nurse is caring for a 2-year-old child who is cyanotic and is in the hospital for a cardiac catheterization to repair cardiac defects. The child will be transferred to the pediatric ICU following the procedure. Which of the following is an appropriate nursing action? A. Place on NPO status for 12 hr prior to the procedure. B. Check for iodine or shellfish allergies prior to the procedure. C. Elevate the affected extremity following the procedure. D. Limit fluid intake following the procedure

A,E

A nurse is caring for a child who is suspected of having rheumatic fever. Which of the following manifestations support this diagnosis? (Select all that apply.) A. Erythema marginatum (rash) B. Continuous joint pain of the digits C. Tender, subcutaneous nodules D. Decreased ESR E. Elevated C-reactive protein

A B E

A nurse is caring for an infant. Which of the following are clinical manifestations of coarctation of the aorta? (Select all that apply.) A. Weak femoral pulses B. Cool skin of lower extremities C. Severe cyanosis D. Clubbing of the fingers E. Heart failure

A.Failure to thrive

An infant is being prepared for surgical repair of a ventricular septal defect (VSD). Which of the following problems will be prevented by closing the defect? A.Failure to thrive B. Ventricular dysrhythmias C .Heart block D. Respiratory alkalosis

C. Scheduling care to provide for uninterrupted rest periods

Appropriate intervention is vital for many children with heart disease in order to go on to live active, full lives. Which of the following outlines an effective nursing intervention to decrease cardiac demands and minimize cardiac workload? A. Feeding the infant over long periods B. Allowing the infant to have her way to avoid conflict C. Scheduling care to provide for uninterrupted rest periods D. Developing and implementing a consistent care plan

B. Absent or diminished femoral pulses

Bryce is a child diagnosed with coarctation of aorta. While assessing him, Nurse Zach would expect to find which of the following? A. Squatting posture B. Absent or diminished femoral pulses C. Severe cyanosis at birth D. Cyanotic ("tet") episodes

C. Normal weight for age

Clay is an 8-year-old boy diagnosed with heart failure. Which of the following shows that he is strictly following the directed therapeutic regimen? A. Daily use of an antibiotic B. Pulse rate less than 50 beats/minute C. Normal weight for age D. Elevation in red blood cell (RBC) count

Truncus arteriosus

Failure of septum formation, resulting in a single vessel that comes off of the ventricles

Tetralogy of Fallot

Four defects that result in mixed blood flow

Bacterial endocarditis

Infection of the inner lining of heart and valves

Kawasaki disease

Inflammation of the inner lining of the blood vessels (Vasculitis)

Rheumatic fever

Inflammatory disease that occurs as a reaction to Group A beta-hemolytic streptococcus (GABHS) infection of the throat

D. Apex

It is considered as the bluntly rounded portion of the heart A. Base B. Pericardium C. Aorta D. Apex

Diagnosis of rheumatic fever. Child should demonstrate 2 major criteria or 1 major and 2 minor criteria following an acute infection with GABHS infection. Major: carditis, sub-q nodules, polyarthritis, rash, chorea Minor: fever & arthralgia

Jones criteria

-high fever that persists for more than 5 days -irritability -swollen hands and feet -red throat or tongue -spotty, bright red rash on the back, chest, abdomen, and or groin -swollen lymph glands in the neck -diarrhea -hepatic dysfunction -bilateral joint pain -cardiac manifestations -cervical lymphadenopathy -desquamation of the perineum -red eyes without drainage -bright red chapped lips

Kawasaki disease symptoms of acute phase (1-2weeks)

No manifestations seen except altered lab findings

Kawasaki disease symptoms of convalescent phase (6-8 weeks)

-thrombocytosis -cracked lips -peeling of skin around nails -temporary arthritis -irritability -resolution of fever

Kawasaki disease symptoms of subacute phase (2-4 weeks)

Hypoplastic left heart syndrome

Left side of the heart is underdeveloped. An ASD or patent foramen oval allows for oxygenation of the blood

Gamma globulin and aspirin

Medications for Kawasaki disease

A. Replacing regular nipples with easy-to-suck ones

Mr. and Mrs. Baker's only daughter is diagnosed with heart failure. Which of the following interventions would be appropriate to promote optimal nutrition for the infant? A. Replacing regular nipples with easy-to-suck ones B. Allowing the infant to feed for at least 1 hour C. Providing large feedings evenly spaced every 4 hours D. Offering formula that is high in sodium and calories

D. Jatene Procedure

The procedure that has to be performed in order to shift the high pressure from the right ventricle to the left ventricle in Transposition of the Great Arteries (TGA) is: A. Rashkind Procedure B. Rastelli Procedure C. Pulmonary Artery Banding D. Jatene Procedure

B. Ventricular septal defect, overriding aorta, pulmonic stenosis (PS), and right ventricular hypertrophy

The Foley Family is caring for their youngest child, Justin, who is suffering from tetralogy of Fallot. Which of the following are defects associated with this congenital heart condition? A. Aorta exits from the right ventricle, pulmonary artery exits from the left ventricle, and two noncommunicating circulations B. Ventricular septal defect, overriding aorta, pulmonic stenosis (PS), and right ventricular hypertrophy C. Coarctation of aorta, aortic valve stenosis, mitral valve stenosis, and patent ductus arteriosus D. Tricuspid valve atresia, atrial septal defect, ventricular septal defect, and hypoplastic right ventricle

B. Shunts the combined cardiac output from the pulmonary artery to the systemic circulation

The ductus arteriosus is another fetal structure that is important in the intrauterine life. It functions to: A. Shunts the combined cardiac output from the pulmonary artery to the aorta going to the lungs B. Shunts the combined cardiac output from the pulmonary artery to the systemic circulation C. Shunts the combined cardiac output from the aorta to the pulmonary artery and later to the pulmonary veins D. Shunts the combined cardiac output from the aorta to the pulmonary artery to the right ventricle

C. Monitor urine output One function of endogenous prostaglandins is the maintenance of glomerular filtration, so the healthcare provider will want to ensure there is adequate urine output when giving this drug. The drug should be discontinued if there is a dramatic decrease in urine output.

The healthcare provider has an order to administer indomethacin to an infant with a patent ductus arteriosus. Which intervention is a priority to implement? A. Assess peripheral pulses B. Auscultate lung sounds C. Monitor urine output D. Monitor heart rate and rhythm

B. Congestive heart failure and hypoxemia

The healthcare provider is caring for a child with congenital heart disease. When planning care, monitoring for which of the following complications will be included in the plan of care? A. Increased pulmonary compliance and cyanosis B. Congestive heart failure and hypoxemia C. Bradycardia and hepatomegaly D. Pulmonary hypotension and cyanosis

A. Provide instructions for a monthly immunoglobulin shot during RSV season.

The healthcare provider is planning the discharge for a child with a ventricular septal defect. Which of the following is a priority to include in the discharge instructions? A. Provide instructions for a monthly immunoglobulin shot during RSV season. B. Ensure the parents know how to take the child's blood pressure at home. C. Advise the family provide meals that are low in fat and calories. D. Suggest quiet activities for the child to decrease physical activity.

B. "Your baby needs this drug because it interferes with substances that keep the PDA open."

The healthcare provider is preparing to administer indomethacin to an infant with a persistent patent ductus arteriosus (PDA). The mother of the baby asks why the medication is being given to her baby. What is the healthcare provider's best response? A. "Your baby needs help clearing the extra fluid from the lungs." B. "Your baby needs this drug because it interferes with substances that keep the PDA open." C. "This drug will help your baby's heart contract with a stronger force." D. "This drug is a non-steroidal anti-inflammatory drug, so it will help control your baby's pain."