Deck 21: Alterations in Cardiovascular Function

Question 1

The child and family come to the clinic requesting information about causes of cardiac defects. The father has high incidence of cardiac defects in his family, and the child is frequently cyanotic around the lips. What causes should the nurse tell the family about? Select all that apply.
1) Decreased maternal age
2) Chromosomal abnormalities
3) Fetal exposure to maternal drugs
4) Maternal viral infections
5) Maternal metabolic disorders

Answer 1

2, 3, 4, 5

Question 2

A child is admitted with infective endocarditis. Which nursing intervention is most appropriate for this child?
1) Start an intravenous line.
2) Place the child in contact isolation.
3) Place the child on seizure precautions.
4) Assist with a lumbar puncture.

Answer 2

1

Question 3

The nurse is performing the initial assessment of a child newly diagnosed Kawasaki disease. Which symptoms would the nurse expect to assess with this child?
1) Dry, swollen, fissured lips
2) Nonpalpable lymph nodes
3) Conjunctivitis with exudates
4) Cyanosis of the hands and feet

Answer 3

1

Question 4

The family has just been informed by the healthcare provider that their newborn is diagnosed with a congenital heart defect, Tetralogy of Fallot (TOF). The family tells the nurse that the healthcare provider told them that TOF is comprised of several defects, and they ask the nurse what the defects are. What will the nurse tell the family? Select all that apply.
1) Pulmonary stenosis
2) Coarctation of the aorta
3) Right ventricular hypertrophy
4) Ventral septal defect
5) Overriding aorta

Question 5

The nurse finds that an infant has stronger pulses in the upper extremities than in the lower extremities, and higher blood pressure readings in the arms than in the legs. Which assessment will the nurse perform next on this infant?
1) Pedal pulses
2) Pulse oximetry level
3) Hemoglobin and hematocrit values
4) Blood pressure of the four extremities

Question 6

An infant with tetralogy of Fallot is having a hypercyanotic episode ("tet" spell). Which nursing interventions are appropriate for the nurse to implement for this infant? Select all that apply.
1) Place the child in knee-chest position.
2) Draw blood for a serum hemoglobin.
3) Administer oxygen.
4) Administer morphine and propranolol intravenously as ordered.
5) Administer Benadryl as ordered.

Question 7

The nurse is checking peripheral perfusion to a child's extremity following a cardiac catheterization. Which assessment finding indicates adequate peripheral circulation to the affected extremity?
1) A capillary refill of greater than three seconds
2) A palpable dorsalis pedis pulse but a weak posterior tibial pulse
3) A decrease in sensation with a weakened dorsalis pedis pulse
4) A capillary refill of less than three seconds with palpable warmth

Question 8

A toddler is started on digoxin (Lanoxin) for cardiac failure. Which is the initial symptom the nurse would assess if the child develops digoxin (Lanoxin) toxicity?
1) Lowered blood pressure
2) Tinnitus
3) Ataxia
4) A change in heart rhythm

Question 9

The nurse is teaching the parents of a group of cardiac patients. Which teaching guideline will the nurse include for any child who has undergone cardiac surgery?
1) The child should be restricted from most play activities.
2) The child should be evaluated to determine if prophylactic antibiotics for dental, oral, or upper-respiratory-tract procedures are necessary.
3) The child should not receive routine immunizations.
4) The child can be expected to have a fever for several weeks following the surgery.

Question 10

The nurse is providing care to an adolescent child who is at risk for developing adult-onset cardiovascular disease. Which teaching points will decrease the adolescent's risk? Select all that apply.
1) Encourage a decrease in smoking.
2) Limit fat intake to 20 to 35 percent of intake.
3) Encourage participation in vigorous exercise for at least 30 minutes.
4) Maintain a normal weight.
5) Include high-fat dairy products in the daily diet.

Question 11

Which athletic activity can the nurse recommend for a school-age client with pulmonary-artery hypertension?
1) Cross-country running
2) Soccer
3) Golf
4) Basketball

Question 12

The nurse admits a child with a ventricular septal defect (VSD) to the unit. Which nursing diagnosis for this child is the most appropriate?
1) Impaired Gas Exchange Related to Pulmonary Congestion Secondary to the Increased Pulmonary Blood Flow
2) Deficient Fluid Volume Related to Hyperthermia Secondary to the Congenital Heart Defect
3) Acute Pain Related to the Effects of a Congenital Heart Defect
4) Hypothermia Related to Decreased Metabolic State

Question 13

The nurse is admitting an infant diagnosed with supraventricular tachycardia. Which intervention is the priority for this infant?
1) Apply ice to the face.
2) Perform Valsalva's maneuver.
3) Administer a beta blocker.
4) Prepare for cardioversion.

Question 14

The nurse is providing care to a school-age client admitted to the emergency department following a motor vehicle crash. The client is exhibiting symptoms of hypovolemic shock. Which nursing interventions are appropriate for this client? Select all that apply.
1) Monitor hemoglobin and hematocrit.
2) Monitor liver enzymes.
3) Administer oxygen, as needed.
4) Administer a dextrose solution.
5) Monitor blood glucose.

Question 15

The nurse has admitted a child with tricuspid atresia. The nurse would expect which initial lab result?
1) A high hemoglobin
2) A low hematocrit
3) A high WBC count
4) A low platelet count

Question 16

A child recently had a heart transplant and the nurse teaches the parents the importance of administering cyclosporine A. Which statement by the parents indicates an appropriate understanding of the teaching session?
1) "Cyclosporin A reduces serum-cholesterol level."
2) "Cyclosporin A prevents rejection."
3) "Cyclosporin A treats hypertension."
4) "Cyclosporin A treats infections."

Question 17

A child has been admitted to the hospital unit in congestive heart failure (CHF). Which symptom would the nurse anticipate upon assessment of the child?
1) Weight loss
2) Bradycardia
3) Tachycardia
4) Increased blood pressure

Question 18

The nurse is preparing to discharge an infant with a congenital heart defect. The infant will be cared for at home by the parents until surgery. Which items will the nurse include in the discharge teaching for this infant and family? Select all that apply.
1) Allow the infant to feed for 60 minutes.
2) Hold the infant at a 45-degree angle.
3) Encourage frequent hand hygiene.
4) Notify the health care provider for fever.
5) Pump the breasts and feed with a bottle if weight gain is an issue.

Question 19

The mother of a child with a heart defect is questioning the nurse about the child's diuretic. When teaching the mother about the medication, what should the emphasis from the nurse?
1) Close monitoring of output
2) The digitalization process
3) The possibility that pulses in the child might be weak
4) The child's increased appetite