Nokea
A 2-month-old male presents with tachycardia, dyspnea, tachypnea, and a gallop rhythm with no heart murmur. He was perfectly well until 1 day prior to the episode. The physical examination reveals a heart rate of 235, a temperature of 37.8°C, and a normal blood pressure with warm, well-perfused extremities. The most likely diagnosis is
- A. sepsis
- B. supraventricular tachycardia
- C. ingestion
- D. ventricular tachycardia
Correct Answer: B
Rationale: Supraventricular tachycardia can cause rapid heart rates and heart failure in infants.
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Which intervention should the nurse plan to decrease cardiac demands in an infant with congestive heart disease (CHD)?
- A. Organize nursing activities to allow for uninterrupted sleep.
- B. Allow the infant to sleep through feedings during the night.
- C. Wait for the infant to cry to show definite signs of hunger.
- D. Discourage parents from rocking the infant.
Correct Answer: A
Rationale: The infant requires rest and conservation of energy for feeding. Every effort is made to organize nursing activities to allow for uninterrupted periods of sleep. Whenever possible, parents are encouraged to stay with their infant to provide the holding, rocking, and cuddling that help children sleep more soundly. To minimize disturbing the infant, changing bed linens and complete bathing are done only when necessary. Feeding is planned to accommodate the infant’s sleep and wake patterns. The child is fed at the first sign of hunger, such as when sucking on fists, rather than waiting until he or she cries for a bottle because the stress of crying exhausts the limited energy supply. Because infants with CHD tire easily and may sleep through feedings, smaller feedings every 3 hours may be helpful.
After a computer tomography (CT) scan with intravenous contrast medium, a client returns to the room complaining of shortness of breath and itching. Which intervention should the nurse implement?
- A. Call respiratory therapy to give a breathing treatment
- B. Send another nurse for an emergency tracheotomy set
- C. Prepare a dose of epinephrine (Adrenalin)
- D. Review the client's complete list of allergies
Correct Answer: C
Rationale: Shortness of breath and itching are signs of an allergic reaction to the contrast medium, and epinephrine is the first-line treatment for anaphylaxis.
While looking through the chart of an infant with a congenital heart defect (CHD) of decreased pulmonary blood flow, the nurse would expect which laboratory finding?
- A. Decreased platelet count
- B. Polycythemia
- C. Decreased ferritin level
- D. Shift to the left
Correct Answer: B
Rationale: Chronic hypoxemia in CHD leads to polycythemia as a compensatory mechanism.
All the following conditions are associated with high volume pulse except
- A. Aorta to LV tunnel
- B. Coronary cameral fistula
- C. Neonatal Blalock Taussig shunt
- D. Hemitruncus
Correct Answer: C
Rationale: Neonatal Blalock Taussig shunt is not associated with a high volume pulse.
Which are the most serious complications for a child with Kawasaki disease? Select all that apply.
- A. Coronary thrombosis
- B. Hypocoagulability
- C. Decreased sedimentation time (ESR)
- D. Coronary stenosis
Correct Answer: A
Rationale: The most serious complications of Kawasaki disease involve the coronary arteries, including thrombosis, stenosis, and aneurysms, which can lead to significant cardiac issues.