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The Child with Cardiovascular Dysfunction
– Wong’s Essentials of Pediatric Nursing
(10th Edition)
An infant with an unrepaired tetralogy of Fallot defect is becoming extremely
cyanotic during a routine blood draw. Which interventions should the nurse
implement? Place in order from the highest-priority intervention to the
lowest-priority intervention. Provide the answer using lowercase letters
separated by commas (e.g., a, b, c, d).
a. Administer 100% oxygen by blow-by.
b. Place the infant in knee-chest position.
c. Remain calm.
d. Give morphine subcutaneously or by an existing intravenous line.
ANSWER: b. Place the infant in knee-chest position.
a. Administer 100% oxygen by blow-by.
d. Give morphine subcutaneously or by an existing intravenous line.
c. Remain calm.
A chest radiograph film is ordered for a child with suspected cardiac
problems. The child's parent asks the nurse, "What will the radiograph show
about the heart?" What knowledge about the x-ray should the nurse include
in the response to the parents?
a. Bones of chest but not the heart
b. Measurement of electrical potential generated from heart muscle
c. Permanent record of heart size and configuration
d. Computerized image of heart vessels and tissues
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ANSWER: c. Permanent record of heart size and configuration
A chest radiograph will provide information on the heart size and pulmonary
blood-flow patterns. It will provide a baseline for future comparisons. The heart
will be visible, as well as the sternum and ribs.
Electrocardiography (ECG) measures the electrical potential generated from heart
muscle.
Echocardiography will produce a computerized image of the heart vessels and
tissues by using sound waves.
DIF: Cognitive Level: Understand REF: p. 738
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
The nurse is assessing a child after a cardiac catheterization. Which
complication should the nurse be assessing for?
a. Cardiac arrhythmia
b. Hypostatic pneumonia
c. Heart failure
d. Rapidly increasing blood pressure
ANS: A Cardiac arrhythmia
Because a catheter is introduced into the heart, a risk exists of catheter-induced
dysrhythmias occurring during the procedure. These are usually transient.
Hypostatic pneumonia, heart failure, and rapidly increasing blood pressure are not
risks usually associated with cardiac catheterization.
DIF: Cognitive Level: Apply REF: p. 739
TOP: Integrated Process: Nursing Process: Assessment
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MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
José is a 4-year-old child scheduled for a cardiac catheterization. What should
be included in preoperative teaching?
a. Directed at his parents because he is too young to understand
b. Detailed in regard to the actual procedures so he will know what to expect
c. Done several days before the procedure so that he will be prepared
d. Adapted to his level of development so that he can understand
ANSWER: ANS: D
d. Adapted to his level of development so that he can understand
Preoperative teaching should always be directed at the child's stage of
development. The caregivers also benefit from the same explanations. The parents
may ask additional questions, which should be answered, but the child needs to
receive the information based on developmental level. Preschoolers will not
understand in-depth descriptions and should be prepared close to the time of the
cardiac catheterization.
DIF: Cognitive Level: Apply REF: p. 739
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Health Promotion and Maintenance
Which explanation regarding cardiac catheterization is appropriate for a
preschool child?
a. Postural drainage will be performed every 4 to 6 hours after the test.
b. It is necessary to be completely "asleep" during the test.
c. The test is short, usually taking less than 1 hour.
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d. When the procedure is done, you will have to keep your leg straight for at least
4 hours.
ANSWER: d. when the procedure is done, you will have to keep your leg straight
for at least
4 hours.
ANS: D
The child's leg will have to be maintained in a straight position for approximately 4
hours. Younger children can be held in the parent's lap with the leg maintained in
the correct position. Postural drainage will not be performed unless the child has
corresponding pulmonary problems. The child should be sedated to lie still, but
being completely asleep is not necessary. The test will vary in length of time from
start to finish.
The nurse is caring for a school-age child who has had a cardiac
catheterization. The child tells the nurse that the bandage is "too wet." The
nurse finds the bandage and bed soaked with blood. What is the priority
nursing action?
a. Notify physician
b. Apply new bandage with more pressure
c. Place the child in Trendelenburg position
d. Apply direct pressure above catheterization site
ANSWER: d. Apply direct pressure above catheterization site
If bleeding occurs, direct continuous pressure is applied 2.5 cm (1 inch) above the
percutaneous skin site to localize pressure over the vessel puncture. Notifying a
physician and applying a new bandage can be done after pressure is applied. The
nurse can have someone else notify the physician while the pressure is being
The Child with Cardiovascular Dysfunction
– Wong’s Essentials of Pediatric Nursing
(10th Edition)
An infant with an unrepaired tetralogy of Fallot defect is becoming extremely
cyanotic during a routine blood draw. Which interventions should the nurse
implement? Place in order from the highest-priority intervention to the
lowest-priority intervention. Provide the answer using lowercase letters
separated by commas (e.g., a, b, c, d).
a. Administer 100% oxygen by blow-by.
b. Place the infant in knee-chest position.
c. Remain calm.
d. Give morphine subcutaneously or by an existing intravenous line.
ANSWER: b. Place the infant in knee-chest position.
a. Administer 100% oxygen by blow-by.
d. Give morphine subcutaneously or by an existing intravenous line.
c. Remain calm.
A chest radiograph film is ordered for a child with suspected cardiac
problems. The child's parent asks the nurse, "What will the radiograph show
about the heart?" What knowledge about the x-ray should the nurse include
in the response to the parents?
a. Bones of chest but not the heart
b. Measurement of electrical potential generated from heart muscle
c. Permanent record of heart size and configuration
d. Computerized image of heart vessels and tissues
,2|Page
ANSWER: c. Permanent record of heart size and configuration
A chest radiograph will provide information on the heart size and pulmonary
blood-flow patterns. It will provide a baseline for future comparisons. The heart
will be visible, as well as the sternum and ribs.
Electrocardiography (ECG) measures the electrical potential generated from heart
muscle.
Echocardiography will produce a computerized image of the heart vessels and
tissues by using sound waves.
DIF: Cognitive Level: Understand REF: p. 738
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
The nurse is assessing a child after a cardiac catheterization. Which
complication should the nurse be assessing for?
a. Cardiac arrhythmia
b. Hypostatic pneumonia
c. Heart failure
d. Rapidly increasing blood pressure
ANS: A Cardiac arrhythmia
Because a catheter is introduced into the heart, a risk exists of catheter-induced
dysrhythmias occurring during the procedure. These are usually transient.
Hypostatic pneumonia, heart failure, and rapidly increasing blood pressure are not
risks usually associated with cardiac catheterization.
DIF: Cognitive Level: Apply REF: p. 739
TOP: Integrated Process: Nursing Process: Assessment
,3|Page
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
José is a 4-year-old child scheduled for a cardiac catheterization. What should
be included in preoperative teaching?
a. Directed at his parents because he is too young to understand
b. Detailed in regard to the actual procedures so he will know what to expect
c. Done several days before the procedure so that he will be prepared
d. Adapted to his level of development so that he can understand
ANSWER: ANS: D
d. Adapted to his level of development so that he can understand
Preoperative teaching should always be directed at the child's stage of
development. The caregivers also benefit from the same explanations. The parents
may ask additional questions, which should be answered, but the child needs to
receive the information based on developmental level. Preschoolers will not
understand in-depth descriptions and should be prepared close to the time of the
cardiac catheterization.
DIF: Cognitive Level: Apply REF: p. 739
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Health Promotion and Maintenance
Which explanation regarding cardiac catheterization is appropriate for a
preschool child?
a. Postural drainage will be performed every 4 to 6 hours after the test.
b. It is necessary to be completely "asleep" during the test.
c. The test is short, usually taking less than 1 hour.
, 4|Page
d. When the procedure is done, you will have to keep your leg straight for at least
4 hours.
ANSWER: d. when the procedure is done, you will have to keep your leg straight
for at least
4 hours.
ANS: D
The child's leg will have to be maintained in a straight position for approximately 4
hours. Younger children can be held in the parent's lap with the leg maintained in
the correct position. Postural drainage will not be performed unless the child has
corresponding pulmonary problems. The child should be sedated to lie still, but
being completely asleep is not necessary. The test will vary in length of time from
start to finish.
The nurse is caring for a school-age child who has had a cardiac
catheterization. The child tells the nurse that the bandage is "too wet." The
nurse finds the bandage and bed soaked with blood. What is the priority
nursing action?
a. Notify physician
b. Apply new bandage with more pressure
c. Place the child in Trendelenburg position
d. Apply direct pressure above catheterization site
ANSWER: d. Apply direct pressure above catheterization site
If bleeding occurs, direct continuous pressure is applied 2.5 cm (1 inch) above the
percutaneous skin site to localize pressure over the vessel puncture. Notifying a
physician and applying a new bandage can be done after pressure is applied. The
nurse can have someone else notify the physician while the pressure is being
