HESI RN EXIT CASE STUDY: CONGENITAL HEART
DISEASE UPDATED AND REVISED IN 2024-2025
DECEMBER
Meet the Client: Timmy Hartsell - ANSWER->Joan and Thomas Hartsell
bring their 4-month-old son Timmy to the pediatric emergency
department reporting that something is just not right with him. They
can't really explain it, but they recognize that Timmy is just behaving
differently. The healthcare provider (HCP) completes a thorough
assessment and finds that Timmy is in congestive heart failure (CHF)
and suspects that he has a ventricular septal defect (VSD), a congenital
heart defect.
Clinical Manifestations - ANSWER->Timmy is admitted to the pediatric
unit for treatment of CHF and is to be seen by a pediatric cardiologist
for further cardiac assessment. The nurse interviews Joan and Thomas
and completes Timmy's admission assessment.
The nurse understands that a child is experiencing heart failure when
which symptoms are found? - ANSWER->-Cool extremities.
-Peripheral edema.
-Nasal Flaring.
Which clinical manifestations would the nurse expect to assess in an
infant diagnosed with ventricular septal defect (VSD)? - ANSWER-
>Tachypnea and grunting with intercostal and subcostal retractions.
The nurse continues Timmy's admission assessment and obtains
subjective data from Timmy's parents concerning his normal routine for
feeding, bathing, and playing. - ANSWER->
, Which statement by Joan supports Timmy's diagnosis of CHF? -
ANSWER->"Timmy never seems to get full even when I breastfeed him
for a long time."
Diagnostic Tests - ANSWER->The pediatric cardiologist schedules a
cardiac catheterization for the next day. The nurse prepares the family
and the client for the procedure by answering questions that the family
is asking.
What should the nurse include when teaching Timmy's parents about
post-procedure care? - ANSWER->Explain that they will need to hold
Timmy on their lap maintaining the leg in a straight position
As the nurse obtains informed consent for Timmy's cardiac
catheterization, Thomas says, "I am still not exactly sure why the doctor
has to do the test." - ANSWER->
Which action should the nurse implement? - ANSWER->Notify the
cardiologist and do not allow Thomas to sign the permit.
Nursing Diagnoses and Interventions - ANSWER->When preparing
Timmy's nursing care plan, the nurse identifies that priority nursing
diagnosis as "decreased cardiac output."
Which nursing intervention must be included in Timmy's plan of care
related to this diagnosis? - ANSWER->Assess the infant's peripheral
pulses and capillary refill time.
Joan tells the nurse that Timmy is often irritable and seems hungry all
the time. Joan and Thomas are concerned that Timmy is losing weight
because he gets so exhausted when feeding that he does not eat very
much. The cardiologist requests that Joan stop breastfeeding and start
bottle feeding. The nurse discusses feeding issues and techniques with
DISEASE UPDATED AND REVISED IN 2024-2025
DECEMBER
Meet the Client: Timmy Hartsell - ANSWER->Joan and Thomas Hartsell
bring their 4-month-old son Timmy to the pediatric emergency
department reporting that something is just not right with him. They
can't really explain it, but they recognize that Timmy is just behaving
differently. The healthcare provider (HCP) completes a thorough
assessment and finds that Timmy is in congestive heart failure (CHF)
and suspects that he has a ventricular septal defect (VSD), a congenital
heart defect.
Clinical Manifestations - ANSWER->Timmy is admitted to the pediatric
unit for treatment of CHF and is to be seen by a pediatric cardiologist
for further cardiac assessment. The nurse interviews Joan and Thomas
and completes Timmy's admission assessment.
The nurse understands that a child is experiencing heart failure when
which symptoms are found? - ANSWER->-Cool extremities.
-Peripheral edema.
-Nasal Flaring.
Which clinical manifestations would the nurse expect to assess in an
infant diagnosed with ventricular septal defect (VSD)? - ANSWER-
>Tachypnea and grunting with intercostal and subcostal retractions.
The nurse continues Timmy's admission assessment and obtains
subjective data from Timmy's parents concerning his normal routine for
feeding, bathing, and playing. - ANSWER->
, Which statement by Joan supports Timmy's diagnosis of CHF? -
ANSWER->"Timmy never seems to get full even when I breastfeed him
for a long time."
Diagnostic Tests - ANSWER->The pediatric cardiologist schedules a
cardiac catheterization for the next day. The nurse prepares the family
and the client for the procedure by answering questions that the family
is asking.
What should the nurse include when teaching Timmy's parents about
post-procedure care? - ANSWER->Explain that they will need to hold
Timmy on their lap maintaining the leg in a straight position
As the nurse obtains informed consent for Timmy's cardiac
catheterization, Thomas says, "I am still not exactly sure why the doctor
has to do the test." - ANSWER->
Which action should the nurse implement? - ANSWER->Notify the
cardiologist and do not allow Thomas to sign the permit.
Nursing Diagnoses and Interventions - ANSWER->When preparing
Timmy's nursing care plan, the nurse identifies that priority nursing
diagnosis as "decreased cardiac output."
Which nursing intervention must be included in Timmy's plan of care
related to this diagnosis? - ANSWER->Assess the infant's peripheral
pulses and capillary refill time.
Joan tells the nurse that Timmy is often irritable and seems hungry all
the time. Joan and Thomas are concerned that Timmy is losing weight
because he gets so exhausted when feeding that he does not eat very
much. The cardiologist requests that Joan stop breastfeeding and start
bottle feeding. The nurse discusses feeding issues and techniques with
