NSG 3600 PEDS EXAM 2 QUESTIONS AND ANSWERS
Congestive Heart Failure Etiology - CORRECT ANSWER✅✅Inability of the heart to perform is function of
moving blood forward. Caused by CHD, dysrhythmias, cardiomyopathy, Kawasaki's.
Congestive Heart Failure Signs and Symptoms for Baby - CORRECT ANSWER✅✅Poor feed, poor growth,
irritability, shortness of air, exercise intolerance, peripheral edema (puffy legs and feet). The child uses a
lot of energy in feeding so they can get tired which causes poor feeding.
Congestive Heart Failure Treatment/Interventions - CORRECT ANSWER✅✅Monitor Vital signs, keep the
child comfortable, oxygenation when needed. Give medications (Angiotensin Converting Enzyme -ACE-
Inhibitor (Captopril) Vasodilation, Cardiac Glycoside (Digoxin), Loop Diuretic (Furosemide)).
What is important information to know about Digoxin? - CORRECT ANSWER✅✅Makes the heart pump
harder so we need to make sure we DO NOT give this medication if their heart rate is less than 90 in
infant OR 70 in child. Toxicity of this drug can cause bradycardia and NV.
What is important information we need to know about Furosemide when it comes to Congestive Heart
Failure? - CORRECT ANSWER✅✅We need to watch the potassium levels when it comes to this drug. If
the levels begin to decrease the digoxin levels will increase causing toxicity.
Atrial Septal Defect (ASD) - CORRECT ANSWER✅✅Simple defect of the atria results when the two
septae fail to overlap properly. Will occur in the second intercostal space and is on the LEFT side. Sound
will either be blowing or very harsh. These kids will be surgery due to their defect not closing on its own.
Ventricular Septal Defect (VSD) - CORRECT ANSWER✅✅MOST COMMON! Defect of the ventricles when
the two septae fail to overlap properly. Is in the lower intercostal space. You can feel it with your hand.
The spleen and liver will be enlarged due to extra blood flow. The sound will be very harsh sounding.
Treatment for Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD) - CORRECT
ANSWER✅✅Watch for spontaneous closure, surgical repair, monitor vitals signs, watch for bleeding
tamponade or migration of the device (chest pain, sudden decrease in BP, palpation) Watch oxygenation
and do congestive heart failure management.
,Patent Ductus Arteriosus (PDA) - CORRECT ANSWER✅✅In utero, the shunt serves the purpose to
bypass the lungs. The ducts starts to close usually within 48 hours but can take as long as 1 year. If the
whole is too large we would need to patch it. This causes blood to go into the lungs that is not
oxygenated.
Patent Ductus Arteriosus (PDA) Clinical Manifestations - CORRECT ANSWER✅✅Harsh murmur-Left
subconfiural margin sound machine like and depends on the side of the defect. The smaller it is the
louder it is. Systolic is higher and the Diastolic gets lower. Frequent colds, susceptible to RSV, poor
feeding/poor growth pattern.
Patent Ductus Arteriosus (PDA) Therapeutic Management - CORRECT ANSWER✅✅Medical care is
usually closure by surgery or a transcatheter device. Postop measures are wound care, monitoring vital
signs, hydration/nutrition.
Pulmonic Stenosis: Pathophysiology - CORRECT ANSWER✅✅Malformation of the pulmonary artery or
pulmonic valve. Increase workload on right ventricle.
Pulmonic Stenosis: Clinical Manifestations - CORRECT ANSWER✅✅These kids could have their valve
replace. If any of these kids have oxygen issues while on wall oxygen there are more issues and other
problems.
Pulmonic Stenosis: Therapeutic Management - CORRECT ANSWER✅✅Reducing stressful situations that
may cause high blood pressure. Angioplasty or valvulopasty.
Aortic Stenosis: Pathophysiology - CORRECT ANSWER✅✅Malformation and narrowing in the aorta or
around the aortic valve. Kids can pass out from overexertion and can cause heart failure.
Coarctation of the Aorta: Pathophysiology - CORRECT ANSWER✅✅A narrowing or constriction of the
descending aorta distal to the carotid arteries. Decrease blood pressure and decrease pulses in lower
part of the lower body. Which makes the upper body have bounding and high pressure.
Coarctation of the Aorta: Clinical Manifestations - CORRECT ANSWER✅✅Murmur, Signs of Congestive
Heart Failure, pain in the legs or cyanotic lower extremities, increase pressure to head and upper
extremities, decrease pressure to lower extremities (cold and hard to perfused)
, Coarctation of the Aorta: Therapeutic Management - CORRECT ANSWER✅✅Surgery-Nursing care
consist of post op management.
Cardiac Cath- angioplasty and valvuloplasty.
Captopril (Capoten) or enalapril (Vasotec). Can also give Digoxin and Lasix.
Tricuspid Atresia: Pathophysiology - CORRECT ANSWER✅✅Caused by an error in the formation if the
tricuspid valve. As a single defect this condition is incompatible with life. Most children born with TA also
have ASD or VSD. The deoxygenated blood must reach the pulmonary bed to sustain life. SINGLE DEFECT
where the deoxygenated blood never reaches the lungs which means its impossible for these kids to
survive.
When is a tricuspid atresia found? - CORRECT ANSWER✅✅It is found in prenatal visit at 20 weeks (child
will have surgery right after birth) If not found or caught the baby will turn blue and the baby will need
surgery right away to see where the issue is.
Tricuspid Atresia: Clinical Manifestations - CORRECT ANSWER✅✅Cyanosis-a bluish discoloration of the
skin resulting from poor circulation
Tachycardia-a rapid heartbeat
Dyspnea-difficult or labored breathing.
Tricuspid Atresia: Therapeutic Management - CORRECT ANSWER✅✅Emergency Surgery with Glenn and
Fontan procedures. If there is no ASD or VSD, keep the PDA open by medications.
Total Anomalous Pulmonary Venous Return - CORRECT ANSWER✅✅Pulmonary blood flow returns to
the heart through the right atrium rather than the left. No communication between pulmonary vessels
and left side of the heart. Right side hypertrophies. Blood that does not have oxygen mixes with blood
that is and it goes out into the body.
Total Anomalous Pulmonary Venous Return: Clinical Manifestations - CORRECT ANSWER✅✅Murmur,
cyanosis, respiratory distress, lethargy, poor and rapid breathing, poor feeding, frequent respiratory
infections, signs of heart failure. Complete surgical repair the right side can lead to heart failure and be
very OVER WORK.
Congestive Heart Failure Etiology - CORRECT ANSWER✅✅Inability of the heart to perform is function of
moving blood forward. Caused by CHD, dysrhythmias, cardiomyopathy, Kawasaki's.
Congestive Heart Failure Signs and Symptoms for Baby - CORRECT ANSWER✅✅Poor feed, poor growth,
irritability, shortness of air, exercise intolerance, peripheral edema (puffy legs and feet). The child uses a
lot of energy in feeding so they can get tired which causes poor feeding.
Congestive Heart Failure Treatment/Interventions - CORRECT ANSWER✅✅Monitor Vital signs, keep the
child comfortable, oxygenation when needed. Give medications (Angiotensin Converting Enzyme -ACE-
Inhibitor (Captopril) Vasodilation, Cardiac Glycoside (Digoxin), Loop Diuretic (Furosemide)).
What is important information to know about Digoxin? - CORRECT ANSWER✅✅Makes the heart pump
harder so we need to make sure we DO NOT give this medication if their heart rate is less than 90 in
infant OR 70 in child. Toxicity of this drug can cause bradycardia and NV.
What is important information we need to know about Furosemide when it comes to Congestive Heart
Failure? - CORRECT ANSWER✅✅We need to watch the potassium levels when it comes to this drug. If
the levels begin to decrease the digoxin levels will increase causing toxicity.
Atrial Septal Defect (ASD) - CORRECT ANSWER✅✅Simple defect of the atria results when the two
septae fail to overlap properly. Will occur in the second intercostal space and is on the LEFT side. Sound
will either be blowing or very harsh. These kids will be surgery due to their defect not closing on its own.
Ventricular Septal Defect (VSD) - CORRECT ANSWER✅✅MOST COMMON! Defect of the ventricles when
the two septae fail to overlap properly. Is in the lower intercostal space. You can feel it with your hand.
The spleen and liver will be enlarged due to extra blood flow. The sound will be very harsh sounding.
Treatment for Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD) - CORRECT
ANSWER✅✅Watch for spontaneous closure, surgical repair, monitor vitals signs, watch for bleeding
tamponade or migration of the device (chest pain, sudden decrease in BP, palpation) Watch oxygenation
and do congestive heart failure management.
,Patent Ductus Arteriosus (PDA) - CORRECT ANSWER✅✅In utero, the shunt serves the purpose to
bypass the lungs. The ducts starts to close usually within 48 hours but can take as long as 1 year. If the
whole is too large we would need to patch it. This causes blood to go into the lungs that is not
oxygenated.
Patent Ductus Arteriosus (PDA) Clinical Manifestations - CORRECT ANSWER✅✅Harsh murmur-Left
subconfiural margin sound machine like and depends on the side of the defect. The smaller it is the
louder it is. Systolic is higher and the Diastolic gets lower. Frequent colds, susceptible to RSV, poor
feeding/poor growth pattern.
Patent Ductus Arteriosus (PDA) Therapeutic Management - CORRECT ANSWER✅✅Medical care is
usually closure by surgery or a transcatheter device. Postop measures are wound care, monitoring vital
signs, hydration/nutrition.
Pulmonic Stenosis: Pathophysiology - CORRECT ANSWER✅✅Malformation of the pulmonary artery or
pulmonic valve. Increase workload on right ventricle.
Pulmonic Stenosis: Clinical Manifestations - CORRECT ANSWER✅✅These kids could have their valve
replace. If any of these kids have oxygen issues while on wall oxygen there are more issues and other
problems.
Pulmonic Stenosis: Therapeutic Management - CORRECT ANSWER✅✅Reducing stressful situations that
may cause high blood pressure. Angioplasty or valvulopasty.
Aortic Stenosis: Pathophysiology - CORRECT ANSWER✅✅Malformation and narrowing in the aorta or
around the aortic valve. Kids can pass out from overexertion and can cause heart failure.
Coarctation of the Aorta: Pathophysiology - CORRECT ANSWER✅✅A narrowing or constriction of the
descending aorta distal to the carotid arteries. Decrease blood pressure and decrease pulses in lower
part of the lower body. Which makes the upper body have bounding and high pressure.
Coarctation of the Aorta: Clinical Manifestations - CORRECT ANSWER✅✅Murmur, Signs of Congestive
Heart Failure, pain in the legs or cyanotic lower extremities, increase pressure to head and upper
extremities, decrease pressure to lower extremities (cold and hard to perfused)
, Coarctation of the Aorta: Therapeutic Management - CORRECT ANSWER✅✅Surgery-Nursing care
consist of post op management.
Cardiac Cath- angioplasty and valvuloplasty.
Captopril (Capoten) or enalapril (Vasotec). Can also give Digoxin and Lasix.
Tricuspid Atresia: Pathophysiology - CORRECT ANSWER✅✅Caused by an error in the formation if the
tricuspid valve. As a single defect this condition is incompatible with life. Most children born with TA also
have ASD or VSD. The deoxygenated blood must reach the pulmonary bed to sustain life. SINGLE DEFECT
where the deoxygenated blood never reaches the lungs which means its impossible for these kids to
survive.
When is a tricuspid atresia found? - CORRECT ANSWER✅✅It is found in prenatal visit at 20 weeks (child
will have surgery right after birth) If not found or caught the baby will turn blue and the baby will need
surgery right away to see where the issue is.
Tricuspid Atresia: Clinical Manifestations - CORRECT ANSWER✅✅Cyanosis-a bluish discoloration of the
skin resulting from poor circulation
Tachycardia-a rapid heartbeat
Dyspnea-difficult or labored breathing.
Tricuspid Atresia: Therapeutic Management - CORRECT ANSWER✅✅Emergency Surgery with Glenn and
Fontan procedures. If there is no ASD or VSD, keep the PDA open by medications.
Total Anomalous Pulmonary Venous Return - CORRECT ANSWER✅✅Pulmonary blood flow returns to
the heart through the right atrium rather than the left. No communication between pulmonary vessels
and left side of the heart. Right side hypertrophies. Blood that does not have oxygen mixes with blood
that is and it goes out into the body.
Total Anomalous Pulmonary Venous Return: Clinical Manifestations - CORRECT ANSWER✅✅Murmur,
cyanosis, respiratory distress, lethargy, poor and rapid breathing, poor feeding, frequent respiratory
infections, signs of heart failure. Complete surgical repair the right side can lead to heart failure and be
very OVER WORK.
