Question 1

The nurse is caring for an infant diagnosed with congestive heart disease (CHD).The nurse should plan which intervention to decrease cardiac demands?

Accepted Answer

The infant requires rest and conservation of energy for feeding.Every effort is made to organize nursing activities to allow for uninterrupted periods of sleep.Whenever possible,parents are encouraged to stay with their infant to provide the holding,rocking,and cuddling that help children sleep more soundly.To minimize disturbing the infant,changing bed linens and complete bathing are done only when necessary.Feeding is planned to accommodate the infant's sleep and wake patterns.The child is fed at the first sign of hunger,such as when sucking on fists,rather than waiting until he or she cries for a bottle because the stress of crying exhausts the limited energy supply.Because infants with CHD tire easily and may sleep through feedings,smaller feedings every 3 hours may be helpful.

Question 2

Nursing interventions for the child after a cardiac catheterization include which of the following? (Select all that apply.)

Accepted Answer

The extremity that was used for access for the cardiac catheterization must be checked for temperature and color.Coolness and blanching may indicate arterial occlusion.The child should have a patent peripheral intravenous line to ensure adequate hydration.Allowing ambulation,monitoring vital signs every 2 hours,checking pulses,and removing the pressure dressing after 4 hours are interventions that do not apply to a child after a cardiac catheterization.

Question 3

Which clinical manifestations would the nurse expect to see as shock progresses in a child and decompensated develops? (Select all that apply.)

Accepted Answer

Cool extremities,decreased skin turgor,confusion,somnolence,tachypnea,and poor capillary refill time are beginning signs of decompensated shock.

Question 4

MATCHING
An infant with an unrepaired tetralogy of Fallot defect is becoming extremely cyanotic during a routine blood draw. Which interventions should the nurse implement? Place in order from the highest-priority intervention to the lowest-priority intervention.

-First priority

Accepted Answer

A  D  C  Placing the infant in the knee-chest position increases systemic vascular resistance, which helps reduce right-to-left shunting and improves oxygenation. Administering 100% oxygen helps increase oxygen availability. Giving morphine helps reduce respiratory drive and calm the infant, reducing oxygen demand. Remaining calm is important to avoid further distressing the infant.

Question 5

Which is the acceptable mg/dL level,or below this level,low-density lipoprotein (LDL)cholesterol level for a child from a family with heart disease? _____ Record your answer as a whole number.

Accepted Answer

The answer of Which is the acceptable mg/dL level,or below...

Question 6

MATCHING
An infant with an unrepaired tetralogy of Fallot defect is becoming extremely cyanotic during a routine blood draw. Which interventions should the nurse implement? Place in order from the highest-priority intervention to the lowest-priority intervention.

-Fourth priority

Accepted Answer

The answer of MATCHING
An infant with an unrepaired tetralogy of...

Question 7

The nurse is talking to a parent of an infant with heart failure about feeding the infant.Which statement about feeding the child is correct?

Accepted Answer

The metabolic rate of infants with heart failure is greater because of poor cardiac function and increased heart and respiratory rates.Their caloric needs are greater than those of the average infants,yet their ability to take in the calories is diminished by their fatigue.Infants with heart failure should be fed every 3 hours; a 2-hour schedule does not allow for enough rest,and a 4-hour schedule is too long.Fluids must be carefully monitored because of the heart failure.Infants do not require supplemental oxygen with feedings.

Question 8

MATCHING
An infant with an unrepaired tetralogy of Fallot defect is becoming extremely cyanotic during a routine blood draw. Which interventions should the nurse implement? Place in order from the highest-priority intervention to the lowest-priority intervention.

-Third priority

Accepted Answer

The answer of MATCHING
An infant with an unrepaired tetralogy of...

Question 9

A preschool child is scheduled for an echocardiogram.Parents ask the nurse whether they can hold the child during the procedure.The nurse should answer with which response?

Accepted Answer

Although an echocardiogram is noninvasive,painless,and associated with no known side effects,it can be stressful for children.The child must lie quietly in the standard echocardiographic positions; crying,nursing,being held,or sitting up often leads to diagnostic errors or omissions.Therefore,infants and young children may need a mild sedative; older children benefit from psychologic preparation for the test.The distraction of a video or movie is often helpful.

Question 10

The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot.Which signs and symptoms should the nurse include? (Select all that apply.)

Accepted Answer

The signs and symptoms of heart failure include decreased urinary output,sweating,and poor feeding.Other signs include pale,cool extremities,not warm and flushed,and weight gain,not weight loss.

Question 11

Surgical closure of the ductus arteriosus would bring about what desired effect?

Accepted Answer

The ductus arteriosus allows blood to flow from the higher-pressure aorta to the lower-pressure pulmonary artery,causing a right-to-left shunt.If this is surgically closed,no additional oxygenated blood (from the aorta)will return to the lungs through the pulmonary artery.The aorta carries oxygenated blood to the systemic circulation.Because of the higher pressure in the aorta,blood is shunted into the pulmonary artery and the pulmonary circulation.Edema in the legs and feet is usually a sign of heart failure.This repair would not directly affect the edema.Increasing the oxygenation of blood would not interfere with the return of oxygenated blood to the lungs.

Question 12

Which action by the school nurse is important in the prevention of rheumatic fever?

Accepted Answer

Nurses have a role in prevention-primarily in screening school-age children for sore throats caused by group A b-hemolytic streptococci.They can achieve this by actively participating in throat culture screening or by referring children with possible streptococcal sore throats for testing.Cholesterol and blood pressure screenings do not facilitate the recognition and treatment of group A b-hemolytic streptococci.Salicylates should be avoided routinely because of the risk of Reye's syndrome after viral illnesses.

Question 13

A nurse is conducting discharge teaching to parents about the care of their infant after cardiac surgery.The nurse instructs the parents to notify the physician if what conditions occur? (Select all that apply.)

Accepted Answer

The parents should be instructed to notify the physician after their infant's cardiac surgery for a temperature above 37.7° C (100° F); new,frequent coughing; and any episodes of the infant turning blue or bluer than normal.A respiratory rate of 36 breaths/minute at rest for an infant is within normal expectations,and it is expected that the appetite will increase slowly.

Question 14

What is the initial goal for the treatment of secondary hypertension?

Accepted Answer

Identification of the underlying disease should be the first step in treating secondary hypertension.Weight control and diet are nonpharmacologic treatments for primary hypertension.Digoxin is indicated in the treatment of congestive heart failure.b-Adrenergic receptor blockers are indicated in the treatment of primary hypertension.

Question 15

The nurse is admitting a child with rheumatic fever.Which therapeutic management should the nurse expect to implement?

Accepted Answer

The goal of medical management is the eradication of the hemolytic streptococci.Penicillin is the drug of choice.Salicylates can be used to control the inflammatory process,especially in the joints,and reduce the fever and discomfort.Bed rest is recommended for the acute febrile stage,but it does not need to be strict.The chorea is transient and will resolve without treatment.

Question 16

MATCHING
An infant with an unrepaired tetralogy of Fallot defect is becoming extremely cyanotic during a routine blood draw. Which interventions should the nurse implement? Place in order from the highest-priority intervention to the lowest-priority intervention.

-Second priority

Accepted Answer

Administering 100% oxygen by blow-by is the highest-priority intervention because it will help to increase the infant's oxygen saturation and reduce cyanosis.

Question 17

The nurse is preparing an adolescent for discharge after a cardiac catheterization.Which statement by the adolescent would indicate a need for further teaching?

Accepted Answer

Encourage rest and quiet activities for the first 3 days and avoid strenuous exercise.The child does not need to be on strict bed rest for 3 days.Showers are recommended; children should avoid a tub bath.The pressure dressing is removed the day after the catheterization and replaced by an adhesive bandage to keep the area clean.

Question 18

A nurse is teaching nursing students the physiology of congenital heart defects.Which defect results in decreased pulmonary blood flow?

Accepted Answer

Tetralogy of Fallot results in decreased blood flow to the lungs.The pulmonic stenosis increases the pressure in the right ventricle,causing the blood to go from right to left across the interventricular septal defect.Atrial and ventricular septal defects and patent ductus arteriosus result in increased pulmonary blood flow.

Quiz 42: The Child With Cardiovascular Dysfunction

The nurse is caring for an infant diagnosed with congestive heart disease (CHD) .The nurse should plan which intervention to decrease cardiac demands?

Nursing interventions for the child after a cardiac catheterization include which of the following? (Select all that apply.)

Which clinical manifestations would the nurse expect to see as shock progresses in a child and decompensated develops? (Select all that apply.)

MATCHING An infant with an unrepaired tetralogy of Fallot defect is becoming extremely cyanotic during a routine blood draw. Which interventions should the nurse implement? Place in order from the highest-priority intervention to the lowest-priority intervention. -First priority

Which is the acceptable mg/dL level,or below this level,low-density lipoprotein (LDL)cholesterol level for a child from a family with heart disease? _____ Record your answer as a whole number.

MATCHING An infant with an unrepaired tetralogy of Fallot defect is becoming extremely cyanotic during a routine blood draw. Which interventions should the nurse implement? Place in order from the highest-priority intervention to the lowest-priority intervention. -Fourth priority

The nurse is talking to a parent of an infant with heart failure about feeding the infant.Which statement about feeding the child is correct?

MATCHING An infant with an unrepaired tetralogy of Fallot defect is becoming extremely cyanotic during a routine blood draw. Which interventions should the nurse implement? Place in order from the highest-priority intervention to the lowest-priority intervention. -Third priority

A preschool child is scheduled for an echocardiogram.Parents ask the nurse whether they can hold the child during the procedure.The nurse should answer with which response?

The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot.Which signs and symptoms should the nurse include? (Select all that apply.)

Surgical closure of the ductus arteriosus would bring about what desired effect?

Which action by the school nurse is important in the prevention of rheumatic fever?

A nurse is conducting discharge teaching to parents about the care of their infant after cardiac surgery.The nurse instructs the parents to notify the physician if what conditions occur? (Select all that apply.)

What is the initial goal for the treatment of secondary hypertension?

The nurse is admitting a child with rheumatic fever.Which therapeutic management should the nurse expect to implement?

MATCHING An infant with an unrepaired tetralogy of Fallot defect is becoming extremely cyanotic during a routine blood draw. Which interventions should the nurse implement? Place in order from the highest-priority intervention to the lowest-priority intervention. -Second priority

The nurse is preparing an adolescent for discharge after a cardiac catheterization.Which statement by the adolescent would indicate a need for further teaching?

A nurse is teaching nursing students the physiology of congenital heart defects.Which defect results in decreased pulmonary blood flow?