PEDS Chapter 19 Cardiovascular

A 9-year-old child has undergone a cardiac catheterization and is being prepared for discharge. The nurse is instructing the parents and child about postprocedure care. Which statement by the parents indicates that the teaching was successful?

"He should avoid taking a bath for about 3 days but he can shower"

A newborn is diagnosed with patent ductus arteriosus. The nurse anticipates that the physician will most likely order which medication?

Indomethacin

The mother of a 4 week old infant is tearful. She reports the physician has told her that her son has a small atrial septal defect. She reports she is worried and asks the nurse more about the condition. Which statement by the parents best indicates an understanding of the nurse's teaching?

"Most of the time this condition spontaneously resolves"

The nurse is caring for an infant girl with a suspected cardiovascular disorder. Which statement by the mother would warrant further investigation?

"The baby seems more comfortable over my shoulder"

The nurse is caring for a newborn diagnosed with an atrial septal defect (ASD). The parents voice concern and state, "I can't believe this is happening. Will our child be okay?" What is the nurse's best response?

"While each case is different, the majority of these defects correct on their own. Let's see what the tests show, then speak with the doctor."

A 7-year-old child with a family history of cardiovascular disease is being screened for hyperlipidemia. When reviewing the child's laboratory test results, which total cholesterol level would be of significant concern?

210 mg/dL

The nurse is developing a plan of care for an infant with heart failure who is receiving digoxin. The nurse would hold the dose of digoxin and notify the physician if the infant's apical pulse rate was:

80 bpm

Auscultation of a child's heart reveals a loud murmur with a precordial thrill. The nurse documents this as which grade?

Grade IV

The nurse is caring for an infant with suspected patent ductus arteriosus. Which assessment finding would the nurse identify as helping to confirm this suspicion?

Harsh, continuous, machine-like murmur under the left clavicle

The nurse is conducting a physical examination of a child with a ventricular septal defect. Which finding would the nurse expect to assess?

Holosystolic harsh murmur along the left sternal border

During a follow-up visit, the parents of a 5-month-old infant diagnosed with congenital heart disease tell the nurse, "We're just so tired and emotionally spent. All these tests and examinations are overwhelming. We just want to have a normal life. We're so focused on the baby that it seems like our 3-year-old is lost

Interrupted family processes related to demands of caring for the ill child

A child is diagnosed with Kawasaki disease and is in the acute phase of the disorder. What would the nurse expect the physician to prescribe? Select all that apply.

Intravenous immunoglobulin Acetaminophen Aspirin

After teaching a group of students about acute rheumatic fever, the instructor determines that the teaching was successful when the students identify which assessment finding?

Jerky movements of the face and upper extremities

A nurse is reviewing the medical record of a child and finds that the child has a grade III murmur. After auscultating the child's heart sounds, how would the nurse document this murmur?

Loud without a thrill

The nurse is preparing a teaching plan for the parents of a child who has been diagnosed with a congenital heart defect. What would the nurse be least likely to include?

Maintenance of strict bed rest

The nurse is reviewing the medical record of a child with infective endocarditis. What would the nurse expect to find? Select all that apply.

Microscopic hematuria with urinalysis Electrocardiogram with prolonged PR interval Petechiae on palpebral conjunctiva

When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess?

Strawberry tongue

A nurse is caring for a newborn with congenital heart disease (CHD). Which finding would the nurse interpret as indicating distress?

Subcostal retraction at the time of feeding

The nurse is caring for a child that just returned from a coronary arteriogram in which the catheter was placed through the left femoral artery. Which nursing actions demonstrate knowledge of the procedure? Select all that apply.

The nurse assesses the dorsalis pedis pulse in the left foot. The nurse assesses the puncture site frequently. The nurse tells the parents that the physician will discuss the results of the procedure with them.

A child with a suspected cardiovascular disorder is to undergo diagnostic testing and is scheduled for an echocardiogram. When explaining this test to the child, what would the nurse most likely include?

"A special wand that picks up sound is used to check your heart"

An infant with congenital heart disease is to undergo surgery to correct the defect. The mother states, "I guess I'm going to have to stop breastfeeding her." Which response by the nurse would be most appropriate?

"Breast milk may help to boost her immune system, so you can continue to use it"

The nurse is caring for a 2-month-old infant who has been diagnosed with acute heart failure. The nurse is providing teaching about nutrition. Which statement by the mother indicates a need for further teaching?

"I need to feed him every hour to make sure he eats enough"

A nurse is working with an adolescent who is slightly overweight and was recently diagnosed with hypertension. They are discussing nutritional management. Which statement by the adolescent demonstrates understanding of the information?

"I should eat plenty of fresh fruits and vegetables"

The nurse is administering digoxin as ordered and the child vomits the dose. What should the nurse do next?

Administer next dose as ordered in 12 hours

After assessing a child's blood pressure, the nurse determines the pulse pressure and finds that it is narrowed. What would the nurse identify as associated with this finding?

Aortic stenosis

After teaching a class about the hemodynamic characteristics of congenital heart disease, the instructor determines that the teaching has been successful when the class identifies which defect as an example of a disorder involving increased pulmonary blood flow?

Atrial septal defect

A child with heart failure is receiving supplemental oxygen. The nurse understands that in addition to improving oxygen saturation, this intervention also has what effect?

Cause vasodilation

The nurse is conducting a physical examination of a child with a suspected cardiovascular disorder. Which finding would the nurse most likely expect to assess if the child had transposition of the great vessels?

Significant cyanosis without presence of a murmur

The nurse is assessing a child with suspected infective endocarditis. Which assessment finding would the nurse interpret as a sign of extracardiac emboli?

Roth spots

A child with suspected dyslipidemia undergoes laboratory testing. The nurse is reviewing the results. Which finding would the nurse interpret as supporting the diagnosis? Select all that apply.

Total cholesterol level of 220 mg/dL LDL level of 140 mg/dL