Test 2 - Peds

A nursing action that promotes ideal nutrition in an infant with congestive heart failure (CHF) is: 1. Feeding formula that is supplemented with additional calories. 2. Allowing the infant to nurse at each breast for 20 minutes. 3. Providing large feedings every 5 hours. 4. Using firm nipples with small openings to slow feedings.

1. Feeding formula that is supplemented with additional calories.

A child diagnosed with congestive heart failure (CHF) is receiving maintenance doses of digoxin and furosemide. She is rubbing her eyes when she is looking at the lights in the room, and her HR is 70 beats per minute. The nurse expects which laboratory finding? 1. Hypokalemia. 2. Hypomagnesemia. 3. Hypocalcemia. 4. Hypophosphatemia.

1. Hypokalemia.

A 10-year-old has undergone a cardiac catheterization. At the end of the procedure, the nurse should first assess: 1. Pain. 2. Pulses. 3. Hemoglobin and hematocrit levels. 4. Catheterization report.

2. Pulses

A heart transplant may be indicated for a child with severe heart failure and: 1. Patent ductus arteriosus (PDA). 2. Ventricular septal defect (VSD). 3. Hypoplastic left heart syndrome. 4. Pulmonic stenosis (PS).

3. Hypoplastic left heart syndrome

During play, a toddler with a history of tetralogy of Fallot (TOF) might assume which position? 1. Sitting. 2. Supine. 3. Squatting. 4. Standing.

3. Squatting

During a well-child checkup for an infant with tetralogy of Fallot (TOF), the child develops severe respiratory distress and becomes cyanotic. The nurse's first action should be to: 1. Lay the child flat to promote hemostasis. 2. Lay the child flat with legs elevated to increase blood flow to the heart. 3. Sit the child on the parent's lap, with legs dangling, to promote venous pooling. 4. Hold the child in knee-chest position to decrease venous blood return.

4. Hold the child in knee-chest position to decrease venous blood return

A nurse is caring for a 2-year-old child who has a heart defect and is scheduled for cardiac catheterization. Which of the following actions should the nurse take? A.) Place on NPO status for 12 hr prior to the procedure. B.) Check for iodine and shellfish allergies prior to the procedure. C.) Elevate the affected extremity following the procedure. D.) Limit fluid intake following the procedure.

B

A nurse is assessing an infant who has heart failure. Which of the following findings should the nurse expect? SATA. A.) Bradycardia B.) Cool extremities C.) Peripheral edema D.) Increased urinary output E.) Nasal flaring

B, C, E

The nurse is aware that a common physiologic adaptation of children with tetralogy of Fallot is: Clubbing of fingers Slow, irregular respirations Subcutaneous hemorrhages Decreased red blood cell count

Clubbing of fingers

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

D Aneurysm formation

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

D Tetralogy of Fallot

A child who has reddened eyes with no discharge; red, swollen, and peeling palms and soles of the feet; dry, cracked lips; and a "strawberry tongue" most likely has _____________________.

Kawasaki disease or KD.

An infant with tetralogy of Fallot becomes cyanotic and dyspneic after a crying episode. To relieve the cyanosis and dyspnea, the nurse should place the infant in the: Orthopneic position Knee-chest position Lateral Sims' position Semi-Fowler's position

Knee-chest position

A 10-year-old child is recovering from a severe sore throat. The parent states that the child complains of chest pain. The nurse observes that the child has swollen joints, nodules on the fingers, and a rash on the chest. The likely cause is _____________________.

rheumatic fever

What congenital heart defect causes cyanosis in children? Atrial septal defect Coarctation of the aorta Ventricular septal defect Transposition of the great vessels

transposition of the great vessels

Breathing stimulates the closure of the Ductus arteriosis. True False

true

In the developing fetus, the ductus arteriosus (DA), is a shunt connecting the pulmonary artery to the aortic arch. True False

true

A one month old infant is admitted for confirmation of the diagnosis of ventricular septal defect. During the initial admission assessment, the nurse would expect to find: Bradycardia at rest Bounding peripheral pulses An activity related cyanosis A murmur at the left sternal border.

A murmur at the left sternal border.

A nurse is assessing an infant who has a coarctation of the aorta. Which of the following findings should the nurse expect? (SATA). a.) Weak formoral pulses b.) cool skin over extremities c.) severe cyanosis d.) clubbing of fingers e.) low blood pressure

A, B, E

A 1-year-old with postductal coarctation of the aorta is admitted to the acute care unit for treatment. When performing an assessment, the nurse finds that the lower extremities are cool. Which finding should the nurse anticipate as the assessment continues? Lethargy Low blood pressure in the arms Low blood pressure in the legs Bilateral pedal edema

Low blood pressure in the legs

A newborn is diagnosed with a congenital heart defect (CHD). The test results reveal that the lumen of the duct between the aorta and pulmonary artery remains open. This defect is known as _____________________.

Patent ductus arteriosus

A nine year old received digoxin (Lanoxin) daily for the past 5 days of his hospitalization. Before giving him his dose this morning, the nurse performs a routine assessment. Which assessment finding indicates the need to hold the child's morning dose of digoxin? Vomiting Palpitations Increased heart rate Serum digoxin level of 1.2 ng/mL

Vomiting

A nurse is teaching the mother of an infant who will take digoxin (Lanoxin) at home to treat a chronic tachyarrhythmia. Which signs of digoxin toxicity should the mother be taught? Blurred vision Heart rate of 180 beats/minute Vomiting two or more feedings Bulging of the anterior fontanel

Vomiting two or more feedings

A child is suspected of having Kawasaki disease. Which finding is significant? Extreme lethargy Increased appetite Respiratory congestion Fever for at least 5 days

Fever for at least 5 days

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

Left to right.

A complete blood workup is ordered for a 5 month old with tetralogy of Fallot. Because of the infant's heart disease, the nurse would expect the report to show: Anemia Polycythemia Agranulocytosis Thrombocytopenia

Polycythemia

An 8 year old is admitted with myocarditis and associated tachycardia, and is prescribed fuosemide (Lasix). Which lab value does the nurse need to closely monitor for this child? Calcium Glucose Potassium Sodium

Potassium

For the child with hypoplastic left heart syndrome, which drug may be given to allow the patent ductus arteriosus (PDA) to remain open until surgery?

Prostaglandin E.

Family discharge teaching has been effective when the parent of a toddler diagnosed with Kawasaki disease (KD) states: 1. "The arthritis in her knees is permanent. She will need knee replacements." 2. "I will give her diphenhydramine (Benadryl) for her peeling palms and soles of her feet." 3. "I know she will be irritable for 2 months after her symptoms started." 4. "I will continue with high doses of Tylenol for her inflammation."

3. "I know she will be irritable for 2 months after her symptoms started."

Congenital heart defects (CHDs) are classified by which of the following? Select all that apply. 1. Cyanotic defect. 2. Acyanotic defect. 3. Defects with increased pulmonary blood flow. 4. Defects with decreased pulmonary blood flow. 5. Mixed defects. 6. Obstructive defects. 7. Pansystolic murmurs.

3. Defects with increased pulmonary blood flow, 4. Defects with decreased pulmonary blood flow, 5. Mixed defects, & 6. Obstructive defects.

A nurse is caring for a child who is suspected of having rheumatic fever. Which of the following findings should the nurse expect? SATA A.) Erythema marginatum (rash) B.) Continuous joint pain of the digits C.) Tender, subQ nodules D.) Decreased ESR E.) Elevated CRP

A, E

A nurse is providing teaching to the caregiver of an infant who has a prescription for digoxin. 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 the correct amount is received.

C

The mother of a child with a congenital cardiac defect asks the nurse why her child squats after exertion. The nurse should reply that this position: Reduces muscle aches Increases cardiac efficiency Enhances the pull of gravity Decreases blood volume in the extremities

increases cardiac effciency