Peas

The nurse provides home care instructions to the parents of a child with heart failure regarding the procedure for administration of digoxin. Which statement made by the parent indicates the need for further instruction?

"If my child vomits after medication administration, I will repeat the dose."

Digoxin level

0.8-2

A child with a diagnosis of tetralogy of Fallot exhibits an increased depth and rate of respirations. On further assessment, the nurse notes increased hypoxemia. The nurse interprets these findings as indicating which situation?

A hypercyanotic episode

The nurse is monitoring an infant with heart failure. Which sign alerts the nurse to suspect fluid accumulation and the need to call the health care provider?

A weight gain of 1 lb (0.5 kg) in 1 day

A 1-year-old infant with a diagnosis of heart failure is prescribed digoxin. The nurse takes the apical pulse for 1 minute before administering the medication and obtains a result of 102 beats/minute. What is the nurse's best action?

Administer the medication.

The nurse is caring for an infant with a diagnosis of tetralogy of Fallot. The infant suddenly becomes cyanotic, and the nurse recognizes that the infant is experiencing a hypercyanotic spell (blue or tet spell). The nurse immediately places the infant in what position?

Knee-chest position

The clinic nurse reviews the record of a child just seen by a health care provider and diagnosed with suspected aortic stenosis. The nurse expects to note documentation of which clinical manifestation specifically found in this disorder?

Exercise intolerance

oxygen at home

safety is main issue, patent flow, educate care, keep nasal moist, pedding for the ears, start at low rate 2L

NEC

shiny and ad. distension, blood in the stool, no BS bowel residual circulation (inflammatory disease) elevate the head of the bed, keep baby calm, maintain fluids, electrolyte balance, thermoregulation

IUGR

small for gestational age, fetal alcohol syndrome,

The nurse is preparing to care for an infant who has esophageal atresia with tracheoesophageal fistula. Surgery is scheduled to be performed in 1 hour. Intravenous fluids have been initiated, and a nasogastric (NG) tube has been inserted by the health care provider. The nurse plans care, knowing that which intervention is of highest priority during this preoperative period?

Aspirate the NG tube every 5 to 10 minutes.

The nurse reviews the record of a newborn infant and notes that a diagnosis of esophageal atresia with tracheoesophageal fistula is suspected. The nurse expects to note which most likely sign of this condition documented in the record?

Choking with feedings, 3 c's cyanotic, and Coughing

The nurse is caring for an infant with a diagnosis of congenital heart disease. Which finding, on physical assessment, does the nurse attribute to chronic hypoxia?

Clubbing of the fingers

The nurse is caring for an infant with congenital heart disease. Which, if noted in the infant, should alert the nurse to the early development of heart failure?

Diaphoresis during feeding

Prostaglandin E1 is prescribed for a child with transposition of the great arteries. The mother of the child is a registered nurse and asks the nurse why the child needs the medication. What is the most appropriate response to the mother about the action of the medication?

Maintains adequate cardiac output

Assessment findings of an infant admitted to the hospital reveal a machinery-like murmur on auscultation of the heart and signs of heart failure. The nurse reviews congenital cardiac anomalies and identifies the infant's condition as which disorder?

Patent ductus arteriosus

The nurse is assigned to care for an infant with tetralogy of Fallot. The mother of the infant calls the nurse to the room because the infant suddenly seems to be having difficulty breathing. The nurse enters the room and notes that the infant is experiencing a hypercyanotic episode. What is the priority action by the nurse?

Place the infant in a knee-chest position.

The nurse is initiating nasogastric tube feedings in a child. What is the nurse's best action?

Position the child with the head slightly hyperflexed.

The nurse is monitoring an infant with congenital heart disease closely for signs of heart failure (HF). The nurse should assess the infant for which early sign of HF?

Tachycardia

The nurse is closely monitoring the intake and output of an infant with heart failure who is receiving diuretic therapy. The nurse should use which most appropriate method to assess the urine output?

Weighing the diapers

A health care provider has prescribed oxygen as needed for an infant with heart failure. In which situation should the nurse administer the oxygen to the infant?

When drawing blood for electrolyte level testing

The nurse is assessing a newborn with heart failure before administering the prescribed digoxin. In reviewing the laboratory data, the nurse notes that the newborn has a digoxin blood level of 1.6 ng/mL (2.05 mmol/L) and an apical heart rate of 90 beats/min. The mother also tells the nurse that the newborn just vomited her formula. Which intervention should the nurse take?

Withhold the medication and notify the health care provider.

The nurse is preparing to administer digoxin to an infant with heart failure. Before administering the medication, the nurse double-checks the dose, counts the apical heart rate for 1 full minute, and obtains a rate of 80 beats/minute. Based on this finding, which is the appropriate nursing action?

Withhold the medication.

Postterm

born after 42wks. large baby

BPD

breath fast, result from RDS, chronic, need energy and increase feeding

CHF-most common signs

failure to thrive

Post-maturity syndrome

hypoglycemia, meconium aspriation, polycynthia, baby can't shiver, peel skin, delivered at 43wks.

the nurse has been assigned to care for a neonate just delivered who has gastroschisis. Which concern should the nurse address in the client's plan of care?

infection

preterm

keep baby warm, keep hat on to prevent cold stress, doesn't have much muscle tone, smooth feet

SGA nursing care

less then 2,500 grams, smoking low o2 demand-hypoxia, risk for immunity, hypoglycemia, res. problems

furosime and HF

loss pottasuim, can cause dig toxicity, wt. diapers-accurate way to monitor.

G-tube

monitor redness, left is open to drain air in order to allow gastrics contents to escape. skin care at site 1/2 hydrogen to remove crusty drainage and rotate tube.

HF

poor wt. gain, early detection- mild tachynea(70-100) 1st sign is tachycardia less energy and difficult feeding

NB with drugs

reduced stimuli, monitor vital sign, nutrition, high pinch cry, irritability, hyperflexibilty, fast breathing

RDS

surfactant deficiency in lungs, give o2, conserved energy, fetal alcohol syndrome are at risk, pre terms

BPD S/S

tachypnea, RDS