COPY PEDS CHAPT 19 NURSING CARE OF THE CHILD WITH
A CARDIOVASCULAR DISORDER | GUARANTEED SUCCESS
STARTS HERE! LEARN, PRACTICE & EXCEL!
You would teach the mother of a boy with tetralogy of Fallot that if he suddenly becomes
cyanotic and dyspneic to
a) lie him supine with the head turned to one side.
b) lie him prone, being sure he can breathe easily.
c) place him in a semi-Fowler's position in an infant seat.
d) place him in a knee-chest position. Answer: place him in a knee-chest position.
Explanation:
Placing a child in a knee-chest or squatting position traps blood in the legs, allowing the
child to better oxygenate that remaining in the trunk.
A parent asks if the reason her infant has a congenital heart defect is because of something
she did while she was pregnant. What is the best response by the nurse?
a) No, heart defects are mainly caused by genetic factors.
b) The studies show it is impossible to know what causes heart defects.
c) Yes, there is a chance you caused this defect.
d) There are several reasons a baby can have a heart defect, let's talk about those causes.
Answer: There are several reasons a baby can have a heart defect, let's talk about those
causes.
Correct
Explanation:
Focus on the therapeutic communication in this situation, while still obtaining more
information. This will help the nurse explore various options for the cause of the defect with
the parent.
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1
,A child with heart disease is receiving digoxin and a diuretic. Which laboratory test result
would be most important for the nurse to monitor?
a) Erythrocyte sedimentation rate
b) Serum sodium level
c) Oxygen saturation level
d) Serum potassium level Answer: Serum potassium level
Correct
Explanation:
Children receiving diuretics should have serum potassium levels obtained because
diuretics tend to deplete the body of potassium. This is even more important if the child is
also receiving digoxin because low serum potassium levels potentiate or increase the
effect of the drug. Serum sodium levels may be obtained in children with heart failure to
ensure that an increased sodium level is not causing edema. The erythrocyte
sedimentation rate identifies inflammation and is unrelated to the use of diuretics and
digoxin. Oxygen saturation levels may be done to evaluate for hypoxemia, but these results
would be unrelated to the use of digoxin and diuretics.
A parent is asking for more information about their infant's patent ductus arteriosus (PDA).
What would be included in the education?
a) This is caused by an opening that usually closes by 1 week of age.
b) This type of defect is caused by having a genetic predisposition for it.
c) Your child may need multiple surgeries to correct this defect.
d) An IV for fluids will be started immediately. Answer: This is caused by an opening that
usually closes by 1 week of age.
Correct
Explanation:
A PDA is caused by an opening that usually closes by 1 week of age called the ductus
arteriosus. The defect is usually fixed by a single surgery or during a cardiac catheterization
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2
, procedure. IV fluids are not a routine intervention for the PDA. Most of the time a PDA
occurs in premature infants.
After assessing a child, the nurse suspects coarctation of the aorta based on which of the
following?
a) Hepatomegaly
b) Narrow pulse
c) Femoral pulse weaker than brachial pulse
d) Bounding pulse Answer: Femoral pulse weaker than brachial pulse
Explanation:
A femoral pulse that is weak or absent in comparison to the brachial pulse is associated
with coarctation of the aorta. Bounding pulse is characteristic of patent ductus arteriosus
or aortic regurgitation. A narrow or thread pulse is associated with heart failure or severe
aortic stenosis. Hepatomegaly is a sign of right-sided heart failure.
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?
a) "We need to watch for changes in skin color or difficulty breathing."
b) "Strenuous activity should be limited for the next 3 days."
c) "We need to avoid a tub bath for the next 3 days."
d) "The feeling of the heart skipping a beat is common." Answer: "The feeling of the heart
skipping a beat is common."
Explanation:
Reports of heart "fluttering" or "skipping a beat" should be reported to the doctor as this
can be a sign of a complication. This statement is appropriate because tub baths should be
avoided for about 3 days. This statement is appropriate because strenuous activity is
limited for about 3 days. Changes in skin color or difficulty breathing indicate potential
complications that need to be reported.
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
A CARDIOVASCULAR DISORDER | GUARANTEED SUCCESS
STARTS HERE! LEARN, PRACTICE & EXCEL!
You would teach the mother of a boy with tetralogy of Fallot that if he suddenly becomes
cyanotic and dyspneic to
a) lie him supine with the head turned to one side.
b) lie him prone, being sure he can breathe easily.
c) place him in a semi-Fowler's position in an infant seat.
d) place him in a knee-chest position. Answer: place him in a knee-chest position.
Explanation:
Placing a child in a knee-chest or squatting position traps blood in the legs, allowing the
child to better oxygenate that remaining in the trunk.
A parent asks if the reason her infant has a congenital heart defect is because of something
she did while she was pregnant. What is the best response by the nurse?
a) No, heart defects are mainly caused by genetic factors.
b) The studies show it is impossible to know what causes heart defects.
c) Yes, there is a chance you caused this defect.
d) There are several reasons a baby can have a heart defect, let's talk about those causes.
Answer: There are several reasons a baby can have a heart defect, let's talk about those
causes.
Correct
Explanation:
Focus on the therapeutic communication in this situation, while still obtaining more
information. This will help the nurse explore various options for the cause of the defect with
the parent.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,A child with heart disease is receiving digoxin and a diuretic. Which laboratory test result
would be most important for the nurse to monitor?
a) Erythrocyte sedimentation rate
b) Serum sodium level
c) Oxygen saturation level
d) Serum potassium level Answer: Serum potassium level
Correct
Explanation:
Children receiving diuretics should have serum potassium levels obtained because
diuretics tend to deplete the body of potassium. This is even more important if the child is
also receiving digoxin because low serum potassium levels potentiate or increase the
effect of the drug. Serum sodium levels may be obtained in children with heart failure to
ensure that an increased sodium level is not causing edema. The erythrocyte
sedimentation rate identifies inflammation and is unrelated to the use of diuretics and
digoxin. Oxygen saturation levels may be done to evaluate for hypoxemia, but these results
would be unrelated to the use of digoxin and diuretics.
A parent is asking for more information about their infant's patent ductus arteriosus (PDA).
What would be included in the education?
a) This is caused by an opening that usually closes by 1 week of age.
b) This type of defect is caused by having a genetic predisposition for it.
c) Your child may need multiple surgeries to correct this defect.
d) An IV for fluids will be started immediately. Answer: This is caused by an opening that
usually closes by 1 week of age.
Correct
Explanation:
A PDA is caused by an opening that usually closes by 1 week of age called the ductus
arteriosus. The defect is usually fixed by a single surgery or during a cardiac catheterization
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
, procedure. IV fluids are not a routine intervention for the PDA. Most of the time a PDA
occurs in premature infants.
After assessing a child, the nurse suspects coarctation of the aorta based on which of the
following?
a) Hepatomegaly
b) Narrow pulse
c) Femoral pulse weaker than brachial pulse
d) Bounding pulse Answer: Femoral pulse weaker than brachial pulse
Explanation:
A femoral pulse that is weak or absent in comparison to the brachial pulse is associated
with coarctation of the aorta. Bounding pulse is characteristic of patent ductus arteriosus
or aortic regurgitation. A narrow or thread pulse is associated with heart failure or severe
aortic stenosis. Hepatomegaly is a sign of right-sided heart failure.
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?
a) "We need to watch for changes in skin color or difficulty breathing."
b) "Strenuous activity should be limited for the next 3 days."
c) "We need to avoid a tub bath for the next 3 days."
d) "The feeling of the heart skipping a beat is common." Answer: "The feeling of the heart
skipping a beat is common."
Explanation:
Reports of heart "fluttering" or "skipping a beat" should be reported to the doctor as this
can be a sign of a complication. This statement is appropriate because tub baths should be
avoided for about 3 days. This statement is appropriate because strenuous activity is
limited for about 3 days. Changes in skin color or difficulty breathing indicate potential
complications that need to be reported.
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
