Nokea
The nurse is caring for a child who has undergone a cardiac catheterization. During recovery, the nurse notices the dressing is saturated with bright red blood. The nurse's first action is to:
- A. Call the interventional cardiologist
- B. Notify the cardiac catheterization laboratory that the child will be returning
- C. Apply a bulky pressure dressing over the present dressing
- D. Apply direct pressure 1 inch above the puncture site
Correct Answer: D
Rationale: Direct pressure above the puncture site helps control bleeding by localizing pressure over the vessel.
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In the treatment of hypothyroidism in children:
- A. Levodopa is the treatment of choice
- B. Levothyroxine should be used
- C. Triiodothyronine is the first line treatment
- D. Carbimazole is indicated
Correct Answer: B
Rationale: Levothyroxine is the treatment of choice for hypothyroidism, as it replaces the deficient thyroid hormone and helps normalize metabolic functions.
Factors triggering renin stimulation:
- A. Hyponatraemia
- B. ACTH
- C. Hypovolaemia
- D. ANP
Correct Answer: C
Rationale: Hypovolaemia
Phenytoin is used for treatment of
- A. supraventricular tachycardia
- B. digitalis intoxication
- C. atrial fibrillation
- D. ventricular tachycardia
Correct Answer: B
Rationale: Phenytoin is used specifically for digitalis-induced arrhythmias.
All the following are correct about left ventricular assist device implantation, except
- A. LA pressure is reduced more than RA pressure
- B. A PFO/small ASD is created following LVAD implantation for decompressing LA
- C. Right to left shunting at atrial level can produce systemic desaturation
- D. RV failure is a bad prognostic marker
Correct Answer: B
Rationale: A PFO/small ASD is not typically created following LVAD implantation.
Appropriate investigations in the emergency management of a 4-year-old presenting in a coma:
- A. Serum magnesium level
- B. Throat swabs
- C. Arterial blood gas
- D. CT scan
Correct Answer: C
Rationale: Arterial blood gas analysis is crucial in the emergency management of a comatose child to assess oxygenation, ventilation, and acid-base status.