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Peds: Chapter 23 Cardiac Questions
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What procedure uses high frequency sound waves obtained by a transducer to produce an image of cardiac structures?
a. ECHO
b. Electocardiography
c. Cardiac cath
d. Electrophysiology ✔✔A. ECHO
- must lie completely still
After a patient returns from cardiac catheterization, the nurse notes that the pulse distal to the catheter insertion site is weaker (+1). The most appropriate nursing intervention is to:
a. elevate the affected extremity
b. document the findings and continue to monitor
c. notify the HCP of the finding
d. apply warm compresses to the insertion site ✔✔b. document the findings and continue to
monitor
- may be weaker a few hours after
- keep the extremity straight and immobile, elevation is not necessary
- warm compresses would increase the risk of bleeding from the insertion site
Congenital heart defects have traditionally been divided into acyanotic or cyanotic defects. Based on the nurse's knowledge of congenital heart defects, this system in clinical practice is:
a. helpful, because it explains the hemodynamics involved
b. helpful, because children with cyanotic defects are easily identified
c. problematic because cyanosis is rarely present in children
d. problematic, because children with acyanotic heart defects may develop cyanosis ✔✔D.
Problematic, because children with acyanotic heart defects may develop cyanosis
Surgical repair for patent ductus arteriosus (PDA) is done to prevent the complication to:
a. pulmonary infection
b. right to left shunt of blood
c. decreased workload on left side of heart
d. increased pulmonary vascular congestion ✔✔d. Increased pulmonary vascular congestion
- high pressure aorta to low pressure pulmonary artery
c. inability to sweat
d. increased urinary output ✔✔a. tachypnea
- one of the early signs of CHF
- tachycardia at rest, dyspnea, retractions, and activity intolerance are other physical signs and symptoms
The nurse should explain to the parents that their child is receiving furosemide (Lasix) for severe congestive heart failure because its effects as
a. a diuretic
b. beta blocker
c. form of digitalis
d. an ACE inhibitor ✔✔a. a diuretic
- loop diuretic
- eliminates excess water and salt to prevent accumulation of fluid associated with CHF
The nurse is preparing to give digoxin to a 9 month infant. The nurse checks the dose; 4 ml of the drug is to be drawn up. Based on the nurse's knowledge of this medication and safe pediatric dosages, the most appropriate action by the nurse is
a. do not draw-up dose; suspect dosage error
b. mix dose with juice to disguise its taste
c. check heart rate; administer dose by placing it to the back and side of mouth
d. check heart rate; administer dose by letting infant suck it through a nipple ✔✔a. do not draw
up dose; suspect dosage error
- prescribed in mcg
- rarely is more than 1 ml administered to an infant
Nursing care of the infant and child with congestive heart failure includes
a. force fluids appropriate to age
b. monitor respirations during active periods
c. organized activities to allow for uninterrupted sleep
d give larger feedings less often to conserve energy ✔✔c. organize activities to allow for
uninterrupted sleep
- needs to be well rested before feeding
- needs should be met to minimize crying
- must organize care to decrease energy expenditure
- children cannot tolerate larger feedings: small frequent feedings should be given to the child in CHF
c. increased exercise and fitness
d. treatment of underlying cause ✔✔d. treatment of underlying cause
- usually necessary to treat the problem before the HTN will be resolved
- weight reduction and limiting salt are effective in essential htn
What should the nurse recognize as an early clinical sign of compensated shock in a child?
a. confusion
b. sleepiness
c. hypotension
d. apprehensiveness ✔✔d. apprehensiveness
- confusion is indicative of compensated shock
- hypotension is a sign of irreversible shock
A cardiac assessment is required to determine if a child's physical symptoms are related to possible heart disease. The nurse is proceeding to auscultation techniques. When observing the nursing student perform this assessment, which action would indicate that additional training was required?
a. documentation of heart sounds in reference to anatomical location
b. determination that there is no evidence of carotid bruits
c. calculation of HR
d. ascertaining whether there is evidence of splenic enlargement ✔✔d. ascertaining whether
there is evidence of splenic enlargement
A physician suspects that a child may have a congenital cardiac disease. Which noninvasive diagnostic procedure would help to confirm the possibility of heart disease?
a. EKG
b. ECHO
c. chest x ray
d. pulse ox ✔✔b. ECHO
The goals of therapeutic management for CHF is to
a. increase afterload and perfusion to tissues.
b. decrease preload and increase afterload
c. decrease preload, afterload and increase contractility
d. decrease contractility and increase preload and afterload ✔✔c. decrease preload and afterload
& increase contractility
- it is fine to individualize care to meet the patients needs = aka taking a night to decrease symptoms
A diagnosis of rheumatic fever is being ruled out for a child. Which lab test(s) is/are the most reliable? (select all)
a. throat culture
b. CRP
c. ASO titer
d. elevated WBC
e. ESR ✔✔c. ASO titer
