PEDS Ch.41 PREPU
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."
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."
A nurse is examining a 10-year-old girl who has a heart murmur. On auscultation, the nurse finds that the murmur occurs only during systole, is short, and sounds soft and musical. When she has the girl stand, she can no longer hear the murmur on auscultation. Which of the following should the nurse say to the girl's mother in response to these findings?
"Your daughter has an innocent heart murmur, which is nothing to worry about."
A nurse is examining a 10-year-old girl who has a heart murmur. On auscultation, the nurse finds that the murmur occurs only during systole, is short, and sounds soft and musical. When she has the girl stand, she can no longer hear the murmur on auscultation. Which statement should the nurse make to the girl's mother in response to these findings?
"Your daughter has an innocent heart murmur, which is nothing to worry about."
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." "We need to avoid a tub bath for the next 3 days." "Strenuous activity should be limited for the next 3 days." "We need to watch for changes in skin color or difficulty breathing."
The nurse is caring for a 14-year-old girl with atrial fibrillation. Which medication would the nurse expect to be prescribed?
*Digoxin Alprostadil Furosemide Indomethacin
After assessing a child, the nurse suspects coarctation of the aorta based on a finding of:
*femoral pulse weaker than brachial pulse. bounding pulse. narrow pulse. hepatomegaly.
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:
140 beats per minute. 120 beats per minute. 100 beats per minute. *80 beats per minute.
The nurse is caring for a child with Kawasaki disease who weighs 40 lb (18.2 kg). The health care provider has prescribed aspirin 80 mg/kg divided into 4 daily doses. Aspirin is supplied at 81 mg per tablet. How many tablet(s) will the nurse administer for one dose? Record your answer using one decimal place.
4.5
A nurse is caring for an infant who is experiencing heart failure. What would be the most appropriate care for this infant?
Administer oxygen.
To prevent infective endocarditis in the child with an artificial heart valve, the nurse teaches parents to:
Administer prophylactic antibiotics before dental work.
Medication education on which drug should the nurse provide to the caregivers of a child diagnosed with rheumatic fever?
Aspirin
The nurse is assessing an infant and notes brachial pulses of 2+ and femoral pulses of 1+. Which action will the nurse perform first?
Assess blood pressure in all extremities.
A 5-year-old is being prepared for diagnostic cardiac catheterization, in which the catheter will be inserted in the right femoral vein. What intervention should the nurse take to prevent infection?
Avoid drawing a blood specimen from the right femoral vein before the procedure
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.
Which assessment findings should the nurse expect to see in the infant diagnosed with pulmonary stenosis and heart failure? Select all that apply.
Cyanosis Murmur Right ventricular hypertrophy
A nursing student is reviewing information about medications used to treat congestive heart failure in children. The student demonstrates understanding of the information by identifying which drug as prescribed to increase myocardial contractility?
Digoxin
The nurse is administering medications to the child with congestive heart failure. Large doses of what medication are used initially in the treatment of CHF to attain a therapeutic level?
Digoxin
A nurse suspects a child is experiencing cardiac tamponade after heart surgery. What would be the priority nursing intervention?
Elevate the head of the bed. *Notify the doctor immediately. Administer epinephrine. Observe vitals every two hours.
The nurse is performing echocardiography on a newborn who is suspected of having a congenital heart defect. The child's mother is concerned about the safety of using this on a newborn and wants to know how this technology works. The nurse assures her that this technology is very safe and may be repeated frequently without added risk. What should the nurse mention in explaining how this diagnostic test works?
High-frequency sound waves are directed toward the heart
When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess?
Hirsutism or striae *Strawberry tongue Malar rash Café au lait spots
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.
3s A nurse suspects a child is having cardiac tamponade postoperatively after having cardiac surgery. Which assessment findings would be indicative of this?
Hypotension and narrowing pulse pressures
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 WBC Decreased RBC Decreased WBC *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)
A newborn is diagnosed with patent ductus arteriosus. The nurse anticipates that the physician will most likely order which medication?
Indomethacin
What is the priority nursing diagnosis in the plan of care for a child with a congenital heart disorder?
Ineffective Tissue Perfusion related to inadequate cardiac output
The nurse is caring for child who present to the emergency department with reports of a fever for 5 days. The nurse notes a diffuse maculopapular rash, reddened cracked lips, erythema of hands, and bilateral conjunctivitis and suspects Kawasaki disease. Which nursing action is priority?
Initiate intravenous access.
A 6-year-old girl is diagnosed with pulmonary stenosis. The mother asks the nurse what the likely treatment for this condition will involve. The nurse should tell the mother which of the following?
Insertion of a catheter with an uninflated balloon tip into the affected valve, followed by inflation of the balloon to break up adhesions
A 6-year-old girl is diagnosed with pulmonary stenosis. The mother asks the nurse what the likely treatment for this condition will involve. What should the nurse tell the mother?
Insertion of a catheter with an uninflated balloon tip into the affected valve, followed by inflation of the balloon to break up adhesions
An infant with poor feeding is suspected of having a congenital heart defect. The parents are asking why a chest x-ray is necessary in their infant. What is the best response from the nurse?
It will determine if the heart is enlarged.
A nurse is caring for a child with Kawasaki disease. Which assessment finding would the nurse expect to see?
Peeling hands and feet and fever
A child is diagnosed with tetralogy of Fallot and during a temper tantrum turns blue. What should the nurse do first?
Place child in the knee-to-chest position.
During assessment of an infant diagnosed with tetralogy of Fallot, the nurse notes bluish colored lips and irritability. Which nursing action is priority?
Place in knee-chest position.
An infant with tetralogy of Fallot becomes cyanotic. Which nursing intervention would be the first priority?
Place the infant in the knee-chest position.
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.
Nursing students are reviewing information about cardiopulmonary arrest in children. They demonstrate understanding of the information when they identify which of the following as the most common cause of cardiac arrest?
Respiratory failure
A child returns from cardiac surgery with a central venous pressure catheter in place to monitor central venous pressure. The nurse would ensure that the manometer's zero point is at the level of which of the following?
Right atrium
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
A child with heart disease is receiving digoxin and a diuretic. Which laboratory test result would be most important for the nurse to monitor?
Serum sodium level Erythrocyte sedimentation rate *Serum potassium level Oxygen saturation level
A nurse is caring for a child who is experiencing heart failure. Which assessment data was most likely seen when initially examined?
Tachycardia
A newborn has been diagnosed with a congenital heart disease. Which of the following congenital heart diseases is associated with cyanosis?
Tetralogy of Fallot
When examining a child with congenital heart disease, an organ in the upper right quadrant of the abdomen can be palpated at 4 cm below the rib cage. What would most likely explain this assessment finding?
The liver size increases due to cardiac medications. The spleen size increases due to frequent infection. *The liver size increases in right-sided heart failure. The spleen size increases due to increased destruction of red blood cells.
When examining a child with congenital heart disease, an organ in the upper right quadrant of the abdomen can be palpated at 4 cm below the rib cage. What would most likely explain this assessment finding?
The liver size increases in right-sided heart failure.
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 nurse is caring for a child that just had open-heart surgery and the parents are asking why there are wires coming out of the chest of the infant. What is the best response by the nurse?
These wires are connected to the heart and will detect if your child's heart gets out of rhythm.
Parents are told their infant has a hypoplastic left heart. How would the nurse explain this condition to the family?
This is a problem where the left side of the heart did not develop properly.
A mother asks why her infant with a cyanotic heart defect turns blue. What is the best response by the nurse?
This is due to a decreased amount of oxygen to the peripheral tissue.
A parent is told their infant has a heart defect with a left to right shunt. What is the best way for the nurse to explain this type of shunting to the parent?
This type of shunting causes an increase of blood to the lungs.
The nurse is caring for a child with congestive heart failure and is administering the drug digoxin. At the beginning of this drug therapy, the process of digitalization is done for which reason?
To build the blood levels to a therapeutic level
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.
After assessing a child, the nurse suspects coarctation of the aorta based on a finding of:
femoral pulse weaker than brachial