Question 1

What should the nurse include in discharge teaching as the highest priority for the child with a cardiac dysrhythmia?

Accepted Answer

This could potentially be life-saving for the child.The parents and significant others in the child's life should have CPR training.The digoxin dose is not repeated if the child vomits.Dizziness is a symptom the child should be taught to report to adults so that the physician can be notified.It is not the priority intervention.The child's pulse should be counted before the medication is given.The dose is withheld if the pulse is below the parameters set by the physician.

Question 2

The nurse is admitting a child who has been diagnosed with Kawasaki disease.What is the most serious complication for which the nurse should assess in Kawasaki disease?

Accepted Answer

Coronary artery aneurysms are seen in 20% to 25% of children with untreated Kawasaki disease.Cardiac valvular disease can occur in rheumatic fever.Cardiomyopathies are diseases of the heart muscle,which can occur as a result of congenital heart disease,coronary artery disease,or other systemic disease.Rheumatic fever is not a complication of Kawasaki disease.

Question 3

A nurse is assigned to care for an infant with an unrepaired tetralogy of Fallot.What should the nurse do first when the baby is crying and becomes severely cyanotic?

Accepted Answer

Calming the crying infant is the first response.An infant with unrepaired tetralogy of Fallot who is crying and agitated may eventually lose consciousness.Placing the infant in a knee-chest position will decrease venous return so that smaller amounts of highly saturated blood reach the heart.This should be done after calming the infant.Administering oxygen is indicated after placing the infant in a knee-chest position.Administering morphine sulfate calms the infant and depresses respirations.It may be indicated sometime after the infant has been calmed.

Question 4

A child has a total cholesterol level of 180 mg/dL.What dietary recommendations should the nurse make to the child and the child's parents? (Select all that apply.)

Accepted Answer

A low-fat diet includes using nonfat or low-fat dairy products,limiting red meat intake,and increasing intake of fish,vegetables,whole grains,and legumes.Children should avoid excessive intake of fruit juices and other sweetened drinks,sugars,and saturated fats.

Question 5

A child who weighs 37 pounds needs a dose of lidocaine prior to cardioversion for ventricular tachycardia.What dose does the nurse prepare to administer?
solve using a whole number._____ mg

Accepted Answer

The answer of A child who weighs 37 pounds needs...

Question 6

An adolescent being seen by the nurse practitioner for a sports physical is identified as having hypertension.On further testing,it is discovered the child has a cardiac abnormality.The initial treatment of secondary hypertension initially involves

Accepted Answer

Identification and treatment of the underlying disease should be the first step in treating secondary hypertension.Weight control and diet are non-pharmacologic treatments for primary hypertension.Digoxin is indicated in the treatment of congestive heart failure.Beta-adrenergic receptor blockers may be indicated in the treatment of secondary hypertension,but the main focus is on identifying and treating the underlying cause.

Question 7

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 which 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; new,frequent coughing; and any episodes of the infant turning blue or bluer than normal.A respiratory rate of 36 at rest for an infant is within normal expectations,and it is expected that the appetite will increase slowly.

Question 8

Which defect results in increased pulmonary blood flow?

Accepted Answer

The atrial septal defect results in increased pulmonary blood flow.Blood flows from the left atrium (higher pressure)into the right atrium (lower pressure)and then to the lungs via the pulmonary artery.The other three diseases do not result in increased pulmonary blood flow.

Question 9

Which strategy is appropriate when feeding the infant with congestive heart failure?

Accepted Answer

The infant with congestive heart failure may tire easily,so the feeding should not continue beyond 30 minutes.If inadequate amounts of formula are taken,gavage feedings should be considered.The infant is fed smaller volumes of concentrated formula every 3 hours.

Question 10

The nurse is caring for a child with Kawasaki disease.The child weighs 33 pounds.When initiating aspirin therapy,what dose does the nurse prepare to administer?

Accepted Answer

When initiating aspiring for Kawasaki disease,it is started at the anti-inflammatory dose of 80 to 100 mg/kg divided into four doses a day.This child weighs 15 kg so 100 mg ´ 15 kg = 1500 mg.Divided into four doses is 375 mg four times a day.75 mg once a day is the maintenance dose used for antiplatelet aggregate purposes.81 mg a day is the adult antiplatelet aggregate dose.

Question 11

A common,serious complication of rheumatic fever is

Accepted Answer

Cardiac valve damage is the most significant complication of rheumatic fever.The other three are not common complications of rheumatic fever.

Question 12

The nurse working in the newborn nursery notices an infant who is having circumoral cyanosis.Which CHD does the nurse suspect the child may have? (Select all that apply.)

Accepted Answer

Tetralogy of Fallot is a cyanotic lesion with decreased pulmonary blood flow.The hypoxia results in baseline oxygen saturations as low as 75% to 85%.Even with oxygen administration,saturations do not reach the normal range.Pulmonary atresia is a cyanotic lesion with decreased pulmonary blood flow.The hypoxia results in baseline oxygen saturations as low as 75% to 85%.Even with oxygen administration,saturations do not reach the normal range.TrAnswerposition of the great arteries is a cyanotic lesion with increased pulmonary blood flow.PDA is failure of the fetal shunt between the aorta and the pulmonary artery to close.PDA is not classified as a cyanotic heart disease.Prostaglandin E? is often given to maintain ductal patency in children with cyanotic heart diseases.VSD is the most common type of cardiac defect.The VSD is a left-to-right shunting defect; however,it may be accompanied by other defects.

Question 13

The primary nursing intervention to prevent bacterial endocarditis is which of the following?

Accepted Answer

The objective of nursing care is to counsel the parents of high-risk children about both the need for prophylactic antibiotics for dental procedures and the necessity of maintaining excellent oral health.The child's dentist should be aware of the child's cardiac condition.Dental procedures should be done to maintain a high level of oral health.Prophylactic antibiotics are necessary.Observing children for complications should be done,but maintaining good oral health and prophylactic antibiotics is important.Restricted mobility may or may not be necessary.

Question 14

A nurse is teaching an adolescent about primary hypertension.Which statement made by the adolescent indicates an understanding of primary hypertension?

Accepted Answer

Primary hypertension in children may be treated with weight reduction and exercise programs.Primary hypertension is usually treated with weight reduction and exercise.If ineffective,pharmacologic intervention may be needed.An exercise program in conjunction with weight reduction can be effective in managing primary hypertension in children.

Question 15

A nurse is conducting a class for nursing students about fetal circulation.Which statement is accurate about fetal circulation and should be included in the teaching session?

Accepted Answer

Resistance in the pulmonary circulation is very high because the lungs are collapsed and filled with fluid.Oxygen and nutrients are carried to the fetus by the umbilical vein.The inferior vena cava empties blood into the right atrium.The direction of blood flow and the pressure in the right atrium propel most of this blood through the foramen ovale into the left atrium.Most of the blood in the pulmonary artery flows though the ductus arteriosus into the descending aorta.

Question 16

Which drug is an angiotensin-converting enzyme (ACE)inhibitor?

Accepted Answer

Capoten is an ACE inhibitor.Furosemide is a loop diuretic.Spironolactone blocks the action of aldosterone.Chlorothiazide is a diuretic.

Question 17

The nurse caring for a child diagnosed with acute rheumatic fever should assess the child for which of the following?

Accepted Answer

Arthritis,characterized by tender,warm,erythematous joints,is one of the major manifestations of acute rheumatic fever in the first 1 to 2 weeks of the illness.The child may have had a sore throat previously associated with a group A beta-hemolytic streptococcal infection a few weeks earlier.A sore throat is not a manifestation of rheumatic fever.Hypertension is not associated with rheumatic fever.Desquamation of the fingers and toes is a manifestation of Kawasaki syndrome.

Question 18

A beneficial effect of administering digoxin is that it

Accepted Answer

Digoxin improves cardiac output,which will lead to decreased edema although it is not a diuretic.It does not increase heart size or increase venous pressure.

Question 19

What is the most common causative agent of bacterial endocarditis?

Accepted Answer

S.viridAnswer and S.aureus are the most common causative agents in bacterial (infective)endocarditis.The others are not common causative agents.

Quiz 46: The Child with a Cardiovascular Alteration