Children with congenital heart disease are often able to adapt positively to frustrating situations. Which provides the best explanation for their behavior?
a)They have usually been spoiled by their parents.
b)They have had fewer opportunities to learn to deal with frustrations.
c)They can manipulate others by their reactions.
d)They are developmentally delayed in their socialization.
B- They have had fewer opportunities to learn to deal with frustration.
Administration of which drug is most important in treating an infant with transposition of the great vessels?
a)Digoxin
b)Antibiotics
c)Prostaglandin E
d)Diuretics
C- Prostaglandin E
A 2 yr old was brought by his parents to the ER, because of respiratory distress, elevated temp, & nasal congestion. A loud systolic murmur was noted over his left sternal border. His diagnosis was a large ventricular septal defect. Which abnormal condition results from this defect?
a)Peripheral hypoxia.
b)Elevated hemoglobin and hematocrit.
c)Volume overload in the lungs.
d)Decreased blood pressure.
C- Volume Overload in the lungs
The RN is teaching a nursing student about cyanotic and acyanotic heart defects. Which statement made by student would show they had the correct understanding of this concept?
a) In cyanotic defects, pressure on the right side of the heart is higher than on the left.
b)In cyanotic defects, there is no mixing of oxygenated and unoxygenated blood in systemic circulation.
c)In cyanotic defects, blood is shunted from the left side of the heart to the right.
d)Acyanotic defects are usually much more complex than cyanotic defects.
A- in cyanotic defects, pressure on the right side of the heart is higher than on the left.
A 6 yr old boy has undergone successful surgical repair of the coarctation of the aorta. During the convalescent period, the boy's family will probably need special counseling about??
a)Becoming less protective.
b)Planning the child's educational goals.
c)Learning to avoid physical complaints that can occur with childhood diseases.
d)Maintaining & supporting the child's restricted life-style.
D- Maintaining & supporting the child's restricted life-style.
The parents of a young child with congestive heart failure tell the nurse that they are "nervous" about giving digoxin. The nurse's response should be based on what?
a)It is a very safe, frequently used drug
b)It is difficult to either overmedicate or undermedicate with digoxin
c)Parents lack the expertise necessary to administer digoxin.
d)Parents must learn specific, important guidelines for administration of digoxin.
D- parents must learn specific, important guidelines for administering digoxin
The nurse is teaching a family about the surgery their infant will have to close the ductus arteriosus. The nurse would explain that by doing this surgery which outcome would occur?
a)Stop the loss of unoxygenated blood to the systemic circulation
b)Decrease the edema in legs and feet
c)Increase the oxygenation of blood
d)Prevent the return of oxygenated blood to the lungs
D- prevent the return of oxygenated blood to the lungs
The RN is teaching a nursing student about increased pulmonary blood flow. Which defect results in increase pulmonary blood flow?
a)Pulmonic stenosis
b)Tricuspid atresia
c)Atrial septal defect
d)Transposition of the great arteries
C- Atrial septal defect
A preterm neonate is admitted to the hospital. The physician orders indomethacin. The nurse informs the parents that the medication is given for which reason?
a)To encourage ductal closure.
b)To prevent hypertension.
c)To promote release of surfactant.
d)To protect the immature liver
a- To encourage ductal closure
The nurse is assessing for cyanosis in an infant with cardiovascular disease. Which location on the infant would be the best to assess for this?
a)the child's toes for color.
b)the child's tongue and buccal membrane.
c)the child's lips and the circumoral area.
d)the child's fingertips for color and blanching.
b- the child's tongue & buccal membrane
An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt. Postoperative nursing care should include which of the following?
A) Monitor closely for signs of infection
A major nursing intervention for an infant born with myelomeningocele is to:
A) Protect the sac from injury
An infant is diagnosed with pyloric stenosis. During the assessment of this child, what would the nurse expect to find?
B) Visible peristaltic waves passing from left to right over the epigastric area, dehydration, and weight loss.
A neonate is born with mild clubfeet. When the parents ask the nurse how this will be corrected, the nurse should explain that:
C) Frequent, serial casting is tried first
Which of the following refers to a hernia protrusion of a saclike cyst of meninges, spinal fluid, & a portion of the spinal cord with its nerves through a defect in the vertebral column?
C) Myelomeningocele
When teaching a patient about what to expect when she wears a Milwaukee brace for scoliosis, the nurse should explain that:
A) Frequent adjustments of the brace will be needed, because of rapid growth rates during adolescence
Which of the following is an important consideration when the nurse is discussing enuresis with the parents of a young child?
B) Organic causes that may be related to enuresis should be considered first
What clinical manifestation would suggest hydrocephalus in a neonate?
C) bulging fontanel, dilated scalp veins
Which clinical manifestation of developmental dysplasia of the hip would be seen in the newborn?
B) Positive Ortolani click
The nurse can expect which test result to be elevated with glomerulonephritis?
A) Antistreptolysin in O liter (ASO).
The priority nursing diagnosis for a newborn diagnosed with a diaphragmatic hernia would be:
B) Impaired gas exchange.
The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. Which of the following should be included?
D) Necessity to return to clinic every 1 to 2 weeks.
A 7-year-old boy was admitted yesterday with acute glomerulonephritis and hematuria. He has orders for bed rest, intake and output, blood pressure q2h, a sodium-restricted diet, and daily weights. What additional clinical sign would the nurse expect this child to exhibit?
C) Elevated blood pressure.
An infant with hydrocephalus is scheduled to have a ventriculoperitoneal shunt inserted. Immediately following the procedure, which nursing action would best prevent decompression from excessive CSF flow?
B) Keeping the head of the infant level with the body.
Which of the following problems is most often associated with myelomeningocele?
A) Hydrocephalus
To prevent an infant from damaging the surgical repair of a cleft palate, the nurse would apply,
A) Elbow restraints.
An 18-month-old child has a ventricular septal defect that will be repaired when he is 3 years old. Until then, which instructions to his parents would be most realistic?
D) The child can set his own limits on exercise and activities
A preterm neonate is admitted to the hospital. The physician orders indomethacin. The nurse informs the parents that the medication is given for which reason?
B) To encourage ductal closure.
Normally, pressure on the ___ side of the heart is greater than on the ___ side?
Left
right
If there is an abnormal opening in the heart, oxygenated blood will be shunted from the ____ to the ____, where it will be re-circulated to the ____?
left
right
lungs
What shunt occurs when there is excessive resistance to blood flow in the pulmonary artery or lungs?
Right > Left shunts
This shunt results in oxygenated blood being circulated out of the body?
right > left shunts
In this shunt, tissues become oxygenated deprived, the heart must work harder, and thrombi are more common?
Right > Left Shunt
Patent Ductus Arteriosus,Atrial Septal Defect, Ventricular Septal Defect, what types of blood flow defect are these?
increased pulmonary blood flow defect
List the clinical manifestations of Increased Pulmonary blood flow....
This causes enlarged liver & spleen, and sometimes edema and heart unable to pump blood to pulmonary artery?
Right sided heart failure
this causes congestion in the lungs, with increased pulmonary pressure & edema. also unable to pump blood into systemic circulation?
Left sided heart failure
Which of the following should the nurse expect to note as a frequent complication for a child with congenital heart diagnosis?
A- Susceptibility to respiratory infection
B- Frequent V/D
C- Bleeding tendencies
D- Seizure disorder
A- Susceptibility to respiratory infection
A 22 month old, has been diagnosed with Kawasaki Disease, what is priority nursing diagnosis?
A- frequent assessment for bleeding & GI upset
B- Passive range of motion to facilitate joint movement
C- Use warming blankets
D- Lubricate child lips
A- frequent assessment for bleeding & GI upset
Child diagnosed with TOF becomes upset, crying & thrashing around while a blood specimen is obtained. The child becomes blue & RR increases to 44. What should nurse do first?
A- Obtain order for sedation of child
B- Assess an irregular heart rate & rhythm
C- Explain to child it will only hurt for a short time
D- Place child in knee-to-chest position
D- Place child in knee-to-chest position
What would cause the closure of the foramen ovale after the baby has been delivered?
Decreased blood flow
The nurse is scheduled to administer digoxin elixir to a 6 month old with congenital heart defect. The nurse auscultates an apical pulse rate of 100, what should the nurse do?
administer digoxin and recheck HR in 30 min
Due to poor sucking with cleft lip & palate, what is used for feeding?
Breck feeder or Haberman feeder
what are cleft palate children prone to?
ear infections & oral health problems
this is failure of the esophagus to develop as a continuous tube and associated with maternal history of polyhydraminos?
Esophageal atreasia
These children have excessive drooling, cyanosis, choking, coughing, sneezing, during feedings, returns fluids through nose & mouth, high risk for aspiration?
esophageal atresis
What is diagnosis for esophageal atresia?
by attempting to pass NG tube into stomach
Attempting to pass NG tube into stomach is a diagnosis for what?
esophageal atresia
This is associated with projectile vomiting, with hyperplasia or hypertrophy of the muscle surrounding the sphincter of the stomach...
Pyloric stenosis
What is a major concern for pyloric stenosis?
Dehydration
This is a protrusion of abdominal contents thru abd wall at the junction of umbilical cord & abdomen, usually covered by transparent layer of peritoneum?
Omphalocele
This is a protrusion of bowel through a defect of the abdomen wall, usually to the right of umbilical cord, with NO membrane covering exposed portion?
Gastroschisis
late sign of this is Jelly stools, and this is considered a medical emergency?
Intussusception
what is the size/ capacity of childs bladder?
add 2 to their age, so 4yrs would be 6 oz bladder capacity
What do you want to avoid in a child post op bladder exstrophy surgery?
avoid abduction in the legs
child with Kawasaki disease is irritable, refuses to eat, & exhibits red skin of the hands & feet. What action would the nurse interpret as the priority?
A- apply lotions to hands & feet
B- Offer foods toddler likes
C- Place toddler in quiet environment
D- Encourage parents to get rest
C- Place toddler in quiet environment
in a child with suspected coarctation of the aorta, the nurse would expect to find:
A- strong pedal pulses
B- diminishing carotid pulses
C- normal femoral pulses
D- Bounding pulses in the arms
D- Bounding pulses in the arms
Kawasaki Disease is characterized by which symptoms?
a- high temp for 5 days or longer
b- strawberry tongue
c- red, dry lips
d- abd discomfort
e- splenic dysfunction
f- edema of the hands
g- rash on soles or palms
h- hyperemic conjunctivae
a- high temp for 5 days or longer
b- strawberry tongue
c- red, dry lips
f- edema of the hands
h- hyperemic conjunctivae
Infants with congenital heart defects are at increased risk for ____ ____?
heart failure
Infants with congenital heart defects should be given ____ feedings that are more spread out?
shorter
failure to thrive is usually associated with heart defects? True or False?
True
what should the nurse do first, before administering digoxin to an infant?
take apical pulse for 1 full minute
_____ ______ is when the four chambers dilate & systolic contraction is weakened?
dilated cardiomyopathy
hypertension is a clinical manifestation of what?
Acute glomerulonephritis
Acute renal failure would show a rapid increase in what lab value?
BUN
Diet for Acute renal failure, might be...
cannot handle large amounts of protein, and sodium, potassium, and phosphorus might be restricted as well.
Large amounts of protein should be avoided in what type of patient?
Acute renal failure
cerebral edema, hypoglycemia, & fatty changes in the liver, are all manifestations of what??
Reye syndrome
Positive Gower's sign is a clinical manifestation of what?
MD
MD is a ____ linked disorder, only seen in ____?
X linked, only seen in males
A positive Kernig & Brudzinski sign is a common manifestation of what?
meningitis
a ventriculoperitoneal shunt is placed for ____, which is an imbalanced production & absorption of CSF?
