NUR 113 Ventricular Septal Defect (VSD)

A child diagnosed with congestive heart failure 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 bpm. The nurse expects which laboratory finding? a) hypokalemia b) hypomagnesemia c) hypocalcemia d) hypophophatemia

a) hypokalemia

A 4-month-old is scheduled to take Digoxin for treatment of a ventricular septal defect. The patient's apical pulse is 89 beats per minute. As the nurse you will? Select all that apply:* A. Hold the dose B. Recheck the pulse via the brachial artery C. Administer the dose as scheduled D. Notify the physician

a, d

The nurse is caring for a 9-month old who was born with a congenital heart defect (CHD). Assessment reveals a HR of 160, capillary refill of 4 seconds, bilateral crackles, and sweat on the scalp. These are signs of what?

Congestive heart failure

As the nurse you know that if a patient has a large ventricular septal defect and does not receive treatment, the patient may develop Eisenmenger Syndrome. This syndrome causes?* A. A reversal of blood shunting in the heart from right to left and will cause pulmonary hypertension. B. A reversal of blood shunting in the heart from left to right and will cause cyanosis. C. A reversal of blood shunting in the heart from left to right and will cause pulmonary hypertension. D. A reversal of blood shunting in the heart from right to left and will cause cyanosis.

D. A reversal of blood shunting in the heart from right to left and will cause cyanosis.

An infant has a large ventricular septal defect (VSD). The defect is located in the upper section of the ventricular septum and is near the tricuspid and aortic valve. Based on this description, what type of ventricular septal defect is this? A. Outlet (conal or subarterial) B. Muscular C. Inlet (atrioventricular) D. Membranous

D. Membranous

TRUE or FALSE: The signs and symptoms of a ventricular septal defect are most commonly detected in a baby following birth.

False

A 3-month-old has been diagnosed with a ventricular septal defect (VSD). The flow of blood through the heart is?

Left to right

TRUE or FALSE: A small muscular ventricular septal defect has a high probability of self-closure, and these types of VSDs are found in the lower portion of the ventricular septum.

True

True or False: Patients whose VSD has been repaired early in life are unlikely to have any significant long-term problems.

True

After speaking with the mother of the infant in the previous question, who may have a ventricular septal defect, you auscultate heart sounds. If a ventricular septal defect was present, you may hear a harsh murmur that is _______________________.* A. Located at the lower left sternal border and starts at S1 and extends into S2. B. Located at the upper left sternal border and is continuous during systole. C. Located at the lower left sternal border and is continuous machine-like. D. Located at the upper left sternal border and is only heard during diastole.

A. Located at the lower left sternal border and starts at S1 and extends into S2.

A two-month-old is showing signs and symptoms of heart failure. An echocardiogram is ordered. The test shows the infant has a ventricular septal defect (VSD). Which statement below best describes the blood flow in the heart due to this congenital heart defect? A. "The blood in the heart is shunting from the right ventricle to the left ventricle, which is increasing pulmonary blood flow." B. "The blood in the heart is shunting from the left ventricle to the right ventricle, which is decreasing pulmonary blood flow." C. "The blood in the heart is shunting from the left ventricle to the right ventricle, which is increasing pulmonary blood flow." D. "The blood in the heart is bypassing the left ventricle and is being shunted to the right ventricle, which is decreasing lung blood flow."

C. "The blood in the heart is shunting from the left ventricle to the right ventricle, which is increasing pulmonary blood flow."

The parents of a 3-month-old ask why their baby will not have an operation to correct a ventricular septal defect (VSD). The nurse's best response is? a) It is always helpful to get a second opinion about any serious condition 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 health-care providers to wait until an infants 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) Your baby's defect is small and will likely close on its own by 1 year of age.

A 10-year old has 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) pulses

A concerned mother brings her 3-month-old to the clinic. The mother states the infant seems to be small for its age. In addition, she states the infant fatigues very easily while feeding and rarely finishes a feeding. While collecting a thorough health history, what other signs and symptoms described by the mother may indicate the child has a congenital heart defect, such as a ventricular septal defect? Select all that apply: A. Diarrhea B. Frequent treatment for lung infections C. Excessive wet diapers D. Diaphoresis when nursing E. Swelling in the hands and feet

b, d, e

Which plan would be appropriate in helping to control congestive heart failure in an infant? a) promoting fluid restriction b) feeding a low-salt formula c) feeding in semi-Fowler position d) encouraging breast milk

c) feeding in semi-Fowler position

How often should a child see a cardiologist if the VSD is small or was closed? a) 1-2 years b) 3-6 months c) monthly d) 3-5 years

d) 3-5 years

Patients with VSDs that stay open have a heart infection called

endocarditis