NUR410 PrepU PEDS
A child is having surgery for a congenital heart defect. The parent asks about their 1-year-old's growth and developmental delays and what they can expect after surgery. What is the best response by the nurse?
"After surgery, most children will catch up."
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 feeling of the heart skipping a beat is common."
A nurse is teaching the parents of a child diagnosed with rheumatic fever about prescribed drug therapy. Which statement would indicate to the nurse that additional teaching is needed?
"We can stop the penicillin when her symptoms disappear."
The nurse is caring for a pediatric client diagnosed with tetralogy of Fallot. After speaking with the physician, the parents state to the nurse, "The doctor said something about our child having too many red blood cells. We don't understand how that could happen?" What is the best response by the nurse?
"Your child's body is trying to compensate for the low blood oxygen levels from the heart defect by making more red blood cells, but this makes the heart actually work harder."
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 beats per minute.
A nurse is preparing to administer a prescribed dose of digoxin to an 6-month-old infant. After assessing the infant's apical pulse, the nurse decides to withhold the dose and notify the health care provider. The nurse bases this decision on which apical pulse rate?
80 beats/min
To prevent infective endocarditis in the child with an artificial heart valve, the nurse teaches parents to:
Administer prophylactic antibiotics before dental work.
Coarctation of the aorta demonstrates few symptoms in newborns. What is an important assessment to make on all newborns to help reveal this condition?
Assessing for the presence of femoral pulses
What information would be included in the care plan of an infant in heart failure?
Begin formulas with increased calories.
A 6-year-old girl had a cardiac catheterization at 9 a.m. At 11 a.m. the nurse notes hypotension as compared to baseline. Based on this assessment finding, which of the following would the nurse do first?
Check the insertion site.
The nurse is administering medications to the child with congestive heart failure (CHF). Large doses of what medication are used initially in the treatment of CHF to attain a therapeutic level?
Digoxin
The nurse in a pediatric cardiovascular clinic is talking with the father of a 5-year-old child who underwent cardiac surgery for a heart defect at the age of 3. The father reports that the child has been having increased shortness of breath, tires easily after playing, and has been gaining weight. The nurse is aware that the child is most likely demonstrating symptoms of which acquired cardiovascular disorder?
Heart failure
An infant with a diagnosis of tetralogy of Fallot becomes agitated following a venous blood draw. Cyanosis with rapid, shallow respirations results. What is the priority nursing intervention?
Hold the child in the knee-chest position on one's shoulder.
The young preschool child has congestive heart failure and receives digoxin elixir every 12 hours. The child's apical pulse is 80 beats per minute (bpm) with quiet activity. What will be the next action of the nurse?
Hold the dose and notify the practioner of the heart rate.
The nurse is educating an adolescent female at risk for hypertension. Which interventions will the nurse recommend? Select all that apply.
Increase hours of sleep. Avoid any smoking. Exercise on a daily basis. Maintain a healthy weight.
A nurse is reviewing blood work for a child with a cyanotic heart defect. What result would most likely be seen in a client experiencing polycythemia?
Increased RBC
The nurse is caring for a child with rheumatic fever who has polyarthritis. Which lab result would the nurse most anticipate with this child's diagnosis and symptoms?
Increased erythrocyte sedimentation rate (ESR)
The nurse is planning care for an 8-month-old infant with a ventricular septal defect. Which nursing diagnosis should the nurse use to help guide the care for this patient?
Ineffective tissue perfusion related to inefficiency of the heart as a pump
A nurse is caring for a child with Kawasaki disease. Which assessment finding would the nurse expect to see?
Peeling hands and feet; fever
What should the nurse teach the parents of a child with tetralogy of Fallot to do if the child suddenly becomes cyanotic and dyspneic?
Place in a knee-chest position.
A parent brings an infant in for poor feeding and listlessness. Which assessment data would most likely indicate a coarctation of the aorta?
Pulses weaker in lower extremities compared to upper extremities
An infant with congenital heart disease is not growing and developing adequately. The nurse will institute what feeding strategy?
Raise the caloric density of the feeding beyond 20 calories per ounce.
Which nursing diagnosis will the nurse indicate as priority for the child following cardiac surgery for tetralogy of Fallot?
Risk for ineffective cardiopulmonary tissue perfusion
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 child who is experiencing heart failure. Which assessment data was most likely seen when initially examined?
Tachycardia
A school nurse finds a 10-year-old's blood pressure is over the 95th percentile. The nurse advises the parent to seek medical attention for the child. What outcome would the nurse expect?
The child will need the blood pressure checked two more times.
A nurse is interviewing a mother who is about to give birth. Which response would alert the nurse for a higher potential for a heart defect in the newborn?
The mother states she has lupus.
A shunt is being inserted for a child with pulmonary atresia. Which of the following would the nurse include to explain this procedure to the parents?
The surgery will increase the blood flow to the lungs.
A shunt is being placed on a child with pulmonary atresia. What is the best explanation of this procedure to the parents?
The surgery will increase the blood flow to the lungs.
A mother asks why her infant with a cyanotic heart defect turns blue. What is the nurse's bestexplanation?
This is due to a decreased amount of oxygen to the peripheral tissue.
The nurse has administered oral penicillin as ordered for prophylaxis of endocarditis. The nurse instructs the parents to immediately report which reaction?
Wheezing
The nurse is planning care for an infant with a nursing diagnosis of decreased cardiac output related to a cardiac defect. What is the most appropriate outcome for this nursing diagnosis? The child will:
demonstrate stable vital signs, capillary refill less than 3 seconds, and a urine output of 1-2 mL/kg/hr.
What evaluation best illustrates the effectiveness of furosemide therapy in a child diagnosed with congestive heart failure (CHF)? The child:
has clear breath sounds.
When caring for a child with Kawasaki disease, the nurse would know that:
management includes administration of aspirin and IVIG.
The nurse is caring for a toddler who has a functional heart murmur. The nurse would advise the child's parents that:
this type of murmur is insignificant.
