PREP U CHP 19

"This test uses sound waves to check the heart structures." "This test should not cause your child any pain."

A 4-year-old child is scheduled for an echocardiogram. The nurse is explaining this procedure to the child's parents. Which information would the nurse likely include? Select all that apply.

"After several days, we do not need to keep any dressing on the site." "If our child has pain, we can give acetaminophen or ibuprofen." "If we notice any drainage or bleeding at the site, we will call the health care provider."

A 5-year-old child has undergone a cardiac catheterization and is being prepared for discharge home with the parents. The nurse is teaching the parents how to care for the child at home. The nurse determines that the teaching is successful based on which statement(s) by the parents? Select all that apply.

reduced hemoglobin levels elevated erythrocyte sedimentation rate (ESR)

A child has been admitted to the inpatient unit to rule out acute Kawasaki disease. A series of laboratory tests have been ordered. Which findings are consistent with this disease? Select all that apply.

serum potassium levels serum sodium levels

A child has been prescribed spironolactone. Which laboratory values should be reviewed when following up on this medication? Select all that apply.

Begin synchronized cardioversion.

A child presents to the emergency department with a heart rate of 178 bpm, dizziness, and decreased level of consciousness. The nurse places the child on a cardiac monitor and notes a narrow complex rhythm. The nurse initiates intravenous access and assists the child with a vagal maneuver but continues to note the same rhythm on the monitor. Which action will the nurse perform next?

Ventricular septal defect Patent ductus arteriosus Atrioventricular canal defect

A health care provider and other health team members are discussing congenital heart disorders that increase pulmonary blood flow. Which disorders are topics for this discussion? Select all that apply.

Nausea and vomiting

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

aspirin IV immunoglobulin

A nurse is providing care to a child with Kawasaki disease. Which medication(s) would the nurse expect the health care provider to prescribe? Select all that apply.

pulmonary stenosis overriding aorta right ventricular hypertrophy

A nurse is reading a journal article about congenital heart conditions that are associated with decreased pulmonary blood flow. The nurse demonstrates understanding of the information when she identifies which anomalies as being associated with tetralogy of Fallot? Select all that apply.

"You need to report any symptoms you are having during the test."

An 8-year-old child is scheduled for an exercise stress test. Which instruction would be mostimportant for the nurse to emphasize?

Taking pedal pulses for the first 4 hours

At 3 years of age, a child has a cardiac catheterization. After the procedure, which interventions would be most important?

magnetic resonance imaging (MRI) echocardiogram cardiac catheterization

The health care provider suspects an infant may have a ventricular septal defect. The parents ask the nurse what diagnostic tests the infant will need to have to determine this diagnosis. For what test(s) should the nurse provide education to the family? Select all that apply.

chest pain with activity dizziness with prolonged standing thrill palpated at base of heart

The nurse is assessing a child with aortic stenosis. Which findings would the nurse most likely assess? Select all that apply.

Involuntary limb movement Macular rash on trunk Tender swollen joints

The nurse is assessing a child with suspected rheumatic fever. What assessment findings are consistent with the disease process? Select all that apply.

90/64 mm Hg

The nurse is assessing the blood pressure of a toddler. Which finding would the nurse document as a normal finding?

mild-to-late ejection click at the apex

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

Administer furosemide. Initiate intravenous access. Apply oxygen via oxyhood. Begin indomethacin infusion.

The nurse is caring for a 1-day-old newborn with patent ductus arteriosus with the following vital signs: pulse 160, respirations 80, oxygen saturation 92%, retractions, and crackles noted in bilateral lungs. Which nursing actions are appropriate at this time? Select all that apply.

a cerebrovascular accident (stroke).

The nurse is caring for a 3-month-old infant with history of congenital heart disease. The infant is brought to the emergency department with nausea and vomiting for 3 days. Admission laboratory results confirm dehydration. The nurse realizes that the dehydrated infant is at risk for:

Assess the dressing at the insertion site.

The nurse is caring for a child admitted to the hospital for a cardiac catheterization. Upon return from the cardiac catheterization, which nursing action is priority?

how and when to use the event button

The nurse is caring for a child with suspected heart arrhythmia. The child will wear an ambulatory electrocardiograph monitor for 24 hours. What is the most important instruction for the nurse to give the child and parent during monitoring?

a fixed split-S2 heart sound

The nurse is caring for a newborn in the hospital. Which assessment finding is most concerning?

I know my child uses up a lot of energy feeding but it doesn't seem to cause distress when I breastfeed." "I'm sure it is likely that my baby will be in intensive care after surgery. I believe I can pump so he can still receive my milk." "I hope my baby doesn't have to have feeding through a feeding tube after surgery, but I know that is a possibility." "I have read that human milk fortifier can be added to my breast milk for additional calorie needs if necessary."

The nurse is caring for a newborn who is scheduled for cardiac surgery to correct a diagnosed defect. Which statements by the mother demonstrate understanding of the situation? Select all that apply.

Auscultate heart rate. Measure respiratory rate. Determine ability to suck. Auscultate lung fields for crackles.

The nurse is caring for an infant suspected of having tricuspid atresia. What essential assessment(s) will the nurse complete for this infant? Select all that apply.

Initiate intravenous access.

The nurse is caring for child who present to the emergency department with reports of a fever for 5 days. The nurse notes a diffuse maculopapular rash, reddened cracked lips, erythema of hands, and bilateral conjunctivitis and suspects Kawasaki disease. Which nursing action is priority?

Failure to gain weight

The nurse is collecting data on a 5-year-old child admitted with the diagnosis of congestive heart failure. Which clinical manifestation observed during the physical assessment would be consistent with this diagnosis?

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

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?

accentuated third heart sound

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

penicillin corticosteroids nonsteroidal anti-inflammatory drugs

The nurse is implementing the plan of care for a child with acute rheumatic fever. What treatment(s) would the nurse expect to administer if prescribed? Select all that apply.

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

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 nurse would review the child's 24-hour diet recall.

The nurse is providing education to parents of a child with a blood pressure in the 90th percentile. What would be included in the intervention strategies?

tiring easily when eating shortness of breath when playing crackles on lung auscultation

The nurse is reviewing the health history and physical examination of a child diagnosed with heart failure. What would the nurse expect to find? Select all that apply.

a toddler with tetralogy of Fallot squatting quietly in the corner of the room

The nurse receives the shift report of multiple pediatric clients. Which pediatric client will the nurse see first?

Infuse no more than 4 mg per minute.

The primary health care provider has prescribed intravenous furosemide for a child diagnosed with congestive heart failure (CHF). Which action will the nurse take when administering this medication?

Provide education to the parents. Auscultate lung sounds frequently. Apply a continuous pulse oximeter. Keep oxygen saturation above 75%.

Which collaborative actions will the nurse perform when caring for an infant with transposition of the great arteries scheduled for surgical repair of the defect? Select all that apply.

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

Which finding(s) is a major criterion used to help the health care provider diagnose acute rheumatic fever in a child? Select all that apply.