Chapter 21. Cardiovascular Diseases
1. 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?
a.
Oxygen is carried to the fetus by the umbilical arteries.
b.
Blood from the inferior vena cava is shunted directly to the right ventricle through the foramen
ovale.
c.
Pulmonary vascular resistance is high because the lungs are filled with fluid.
d.
Blood flows from the ductus arteriosus to the pulmonary artery.
ANS: C
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.
,2. Which postoperative intervention should be questioned for a child after a
cardiac catheterization?
a.
Continue intravenous (IV) fluids until the infant is tolerating oral
fluids. b.
Check the dressing for bleeding.
c.
Assess the peripheral circulation on the affected
extremity. d.
Keep the affected leg flexed and elevated.
ANS: D
The child should be positioned with the affected leg straight for 4 to 6 hours after the
procedure. IV fluid administration continues until the child is taking and retaining adequate
amounts of oral fluids. The insertion site dressing should be observed frequently for bleeding.
The nurse should also look under the child to check for pooled blood. Peripheral perfusion is
monitored after catheterization. Distal pulses should be palpable, although they may be weaker
than in the contralateral extremity.
3. Which information should be included in the nurses discharge instructions for a child
who underwent a cardiac catheterization earlier in the day?
a.
, The pressure dressing is changed daily for the first
week. b.
The child may soak in the tub beginning
tomorrow. c.
Contact sports can be resumed in 2
days. d.
The child can return to school on the third day after the procedure.
ANS: D
The child can return to school on the third day after the procedure. It is important to emphasize
follow-up with the cardiologist. The day after the cardiac catheterization, the pressure dressing
is removed and replaced with a Band-Aid. The catheter insertion site is assessed daily for
healing. Any bleeding or sign of infection, such as drainage, must be reported to the
cardiologist. Bathing is limited to a shower, sponge bath, or a brief tub bath (no soaking) for
the first 1 to 3 days after the procedure. Strenuous exercise such as contact sports, swimming,
or climbing trees is avoided for up to 1 week after the procedure.
4. A nurse is preparing to assess a 9-month-old infant admitted to the hospital for further
evaluation of an atrial septal defect (ASD). Which should the nurse do first for the
cardiac assessment?
a.
Percussion
b.
Palpation c.
Auscultation
d.
History and inspection
1. 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?
a.
Oxygen is carried to the fetus by the umbilical arteries.
b.
Blood from the inferior vena cava is shunted directly to the right ventricle through the foramen
ovale.
c.
Pulmonary vascular resistance is high because the lungs are filled with fluid.
d.
Blood flows from the ductus arteriosus to the pulmonary artery.
ANS: C
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.
,2. Which postoperative intervention should be questioned for a child after a
cardiac catheterization?
a.
Continue intravenous (IV) fluids until the infant is tolerating oral
fluids. b.
Check the dressing for bleeding.
c.
Assess the peripheral circulation on the affected
extremity. d.
Keep the affected leg flexed and elevated.
ANS: D
The child should be positioned with the affected leg straight for 4 to 6 hours after the
procedure. IV fluid administration continues until the child is taking and retaining adequate
amounts of oral fluids. The insertion site dressing should be observed frequently for bleeding.
The nurse should also look under the child to check for pooled blood. Peripheral perfusion is
monitored after catheterization. Distal pulses should be palpable, although they may be weaker
than in the contralateral extremity.
3. Which information should be included in the nurses discharge instructions for a child
who underwent a cardiac catheterization earlier in the day?
a.
, The pressure dressing is changed daily for the first
week. b.
The child may soak in the tub beginning
tomorrow. c.
Contact sports can be resumed in 2
days. d.
The child can return to school on the third day after the procedure.
ANS: D
The child can return to school on the third day after the procedure. It is important to emphasize
follow-up with the cardiologist. The day after the cardiac catheterization, the pressure dressing
is removed and replaced with a Band-Aid. The catheter insertion site is assessed daily for
healing. Any bleeding or sign of infection, such as drainage, must be reported to the
cardiologist. Bathing is limited to a shower, sponge bath, or a brief tub bath (no soaking) for
the first 1 to 3 days after the procedure. Strenuous exercise such as contact sports, swimming,
or climbing trees is avoided for up to 1 week after the procedure.
4. A nurse is preparing to assess a 9-month-old infant admitted to the hospital for further
evaluation of an atrial septal defect (ASD). Which should the nurse do first for the
cardiac assessment?
a.
Percussion
b.
Palpation c.
Auscultation
d.
History and inspection
