Unit 4 NU 327 Study Guide with Complete Solutions

Unit 4 NU 327 Study Guide with Complete Solutions *Chest xray*- - Answer--most frequently ordered radiologic test for children Creates permanent record of heart's size and configuration including chambers and the great vessels Pattern of blood flow, especially pulmonary vessels Monitoring your patient after cardiac catheterization - Answer-*Post procedure* Cardiac monitoring/pulse oximetry, VS Q 15", HR for 60 secs Temp and color of affected extremity BP-especially hypotension that could indicate hemorrhage EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 2/10 Dressing for bleeding, hematoma at insertion site *if bleeding occurs apply pressure 1" above site* Fluid intake and output both IV and PO Infants increase risk of hypoglycemia, monitor BS Apical pulse rates for infants/children taking digoxin - Answer-Hold if pulse 90-110 infants and young children 70 in older children 60 in adults Written order should specify hr Check order and dosing with another staff member Guidelines for administering digoxin; lab monitoring; s/s toxicity - Answer-Hold digoxin based on heart rate (see slide) When in doubt, hold dose, call provider, check serum level Apical pulse rate-ascultate one full minute, monitor for alterations in rhythm EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 3/10 Therapeutic Range for digoxin: 0.8 - 2 mcg/L S/S for Toxicity: vomiting, nausea, and bradycardia Management/treatment goals of CHF in infants - Answer-Improve cardiac function -Increase contractility and decrease afterload (digoxin and ACE Inhibitors)) Remove accumulated fluid and sodium -Decrease preload (diuretics) Decrease cardiac demands -Maintain or gain weight (prevent over exertions, promote rest, feeds every 3 hours) Improve tissue oxygenation and decrease o2 consumption (supplemental O2 if necessary - cool humidified air) EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 4/10 patent ductus arteriosus (PDA)-repair prevents what complication? - Answer-Aortic pressure is higher than pulmonary and pushing blood into pulmonary artery. *Repair: PREVENT PULMONARY VASCULAR CONGESTION* S/S of coarctation of aorta - Answer-Narrowing of the aorta High BP and bounding in pulse in arms Low BP and weak pulses in the lower extremities. - Severe acidosis and hypotension Fetal circulation-how is the brain, lungs, liver affected; role of foramen ovale - Answer-The fetal brain requires the highest oxygen concentration The lungs are essentially non-functional; Liver is partially functional. The fetus needs less blood to in these organ during fetal life. EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 5/10 Blood travels from umbilical cord to liver where it divides. To hepatic circulation and the rest to the inferior vena cava via the ductus venosus . Due to the high pressure of oxygen going into RA, a straight pathway (the foramen ovale) opens into the LA. Allows full circulation of the heart. pg 1252 Dental prophylaxis and infective endocarditis - Answer-Antibiotic prophylaxis for all pts with CHD. Administer 1 hour before dental exam to prevent endocarditis Cause of Kawasaki disease - Answer-Unknown etiology S/S of hypokalemia - Answer-muscle weakness & cramps, stiffness, paralysis hyporeflexia, hypotension, cardiac arrhythmia, tachycardia or bradycardia, EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 6/10 ileus (Inability of the intestine (bowel) to contract normally and move waste out of the body), apathy, drowsiness Heart transplantation in children, what are the options - Answer-Orthotopic-implantation of a donor heart Heterotopic-recipients own heart left In place, new heart is implanted to act as additional pump-"piggyback" **Rarely done in children** Environmental factors that contribute to hypertension in children - Answer-pg. 1303 obesity; salt ingestion; smoking; lead exposure; medications (certain stimulus drugs) and stress -ventral septic defect (VSD) - Answer-HF is common MOST COMMON-TYPICALLY MILD(SMALL), may have