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CHAPTER 7: HEART FAILURE

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1. Which congenital heart disease causes cyanosis when not repaired? Select all that apply. a. Patent ductus arteriosus (PDA) b. Tetralogy of Fallot c. Pulmonary atresia d. Transposition of the great arteries ANS: B, C, D 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. Transposition 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 E1 is often given to maintain ductal patency in children with cyanotic heart diseases. 2. A child with heart failure is on Lanoxin (digoxin). The laboratory value a nurse must closely monitor is which? a. Serum sodium b. Serum potassium c. Serum glucose d. Serum chloride ANS: B A fall in the serum potassium level enhances the effects of digoxin, increasing the risk of digoxin toxicity. Increased serum potassium levels diminish digoxins effect. Therefore, serum potassium levels (normal range, 3.55.5 mmol/L) must be carefully monitored. 3. An infant has tetralogy of Fallot. In reviewing the record, what laboratory result should the nurse expect to be documented? a. Leukopenia b. Polycythemia c. Anemia d. Increased platelet level

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C HAPTER 7: H EART F AILURE

1. Which congenital heart disease causes cyanosis when not repaired? Select all that
apply.
a. Patent ductus arteriosus (PDA)
b. Tetralogy of Fallot
c. Pulmonary atresia
d. Transposition of the great arteries



ANS: B, C, D



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 r ange.
Transposition 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 E1 is often given to maintain ductal patency in
children with cyanotic heart diseases.



2. A child with heart failure is on Lanoxin (digoxin). The laboratory value a nurse
must closely monitor is which?
a. Serum sodium
b. Serum potassium
c. Serum glucose
d. Serum chloride

, ANS: B



A fall in the serum potassium level enhances the effects of digoxin, increasing
the risk of digoxin toxicity. Increased serum potassium levels diminish
digoxins effect. Therefore, serum potassium levels (normal range, 3.55.5
mmol/L) must be carefully monitored.



3. An infant has tetralogy of Fallot. In reviewing the record, what laboratory result
should the nurse expect to be documented?
a. Leukopenia
b. Polycythemia
c. Anemia
d. Increased platelet level



ANS: B



Persistent hypoxemia that occurs with tetralogy of Fallot stimulates
erythropoiesis, which results in polycythemia, an increased number of red
blood cells.



4. What child has a cyanotic congenital heart defect?
a. An infant with patent ductus arteriosus
b. A 1-year-old infant with atrial septal defect
c. A 2-month-old infant with tetralogy of Fallot
d. A 6-month-old infant with repaired ventricular septal defect



ANS: C

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