Nokea
The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurses response should be based on which knowledge?
- A. It is a safe, frequently used drug.
- B. Parents lack the expertise necessary to administer digoxin.
- C. It is difficult to either overmedicate or undermedicate with digoxin.
- D. Parents need to learn specific, important guidelines for administration of digoxin.
Correct Answer: D
Rationale: Digoxin?s narrow therapeutic range requires parents to learn specific guidelines for safe administration and monitoring to prevent toxicity. It?s not inherently safe, parents can be taught, and over- or undermedication is a risk without proper guidance.
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The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes the risk of cerebrovascular accidents (strokes) occurring. What strategy is an important objective to decrease this risk?
- A. Minimize seizures.
- B. Prevent dehydration.
- C. Promote cardiac output.
- D. Reduce energy expenditure.
Correct Answer: B
Rationale: Preventing dehydration reduces stroke risk in hypoxic children with polycythemia, as dehydration increases blood viscosity. Seizure control, cardiac output, and energy expenditure are important but don?t directly address stroke risk.
After returning from cardiac catheterization, the nurse determines that the pulse distal to the catheter insertion site is weaker. How should the nurse respond?
- A. Elevate the affected extremity.
- B. Notify the practitioner of the observation.
- C. Record data on the assessment flow record.
- D. Apply warm compresses to the insertion site.
Correct Answer: C
Rationale: A weaker pulse post-catheterization is expected initially and should be documented as a baseline for monitoring. The pulse should strengthen over hours. Elevation, warm compresses, or immediate notification are unnecessary unless neurovascular changes occur.
A cardiac defect that allows blood to shunt from the (high pressure) left side of the heart to the (lower pressure) right side can result in which condition?
- A. Cyanosis
- B. Heart failure
- C. Decreased pulmonary blood flow
- D. Bounding pulses in upper extremities
Correct Answer: B
Rationale: Left-to-right shunting increases pulmonary blood flow, overloading the right heart and leading to heart failure. Cyanosis and decreased pulmonary flow occur with right-to-left shunts, and bounding pulses are specific to coarctation of the aorta.
A 3-month-old infant has a hypercyanotic spell. What should be the nurses first action?
- A. Assess for neurologic defects.
- B. Prepare the family for imminent death.
- C. Begin cardiopulmonary resuscitation.
- D. Place the child in the kneechest position.
Correct Answer: D
Rationale: Placing the infant in the knee-chest position increases systemic vascular resistance, reducing the hypercyanotic spell. Oxygen and morphine may follow, but this is the first action. Neurologic defects, CPR, or preparing for death are inappropriate initial responses.
A chest radiography examination is ordered for a child with suspected cardiac problems. The childs parent asks the nurse, What will the x-ray show about the heart? The nurses response should be based on knowledge that the radiograph provides which information?
- A. Shows bones of the chest but not the heart
- B. Evaluates the vascular anatomy outside of the heart
- C. Shows a graphic measure of electrical activity of the heart
- D. Supplies information on heart size and pulmonary blood flow patterns
Correct Answer: D
Rationale: Chest radiographs reveal heart size and pulmonary blood flow patterns, aiding in cardiac assessment. They also show chest bones, but the heart is visible. Vascular anatomy is evaluated via MRI, and electrical activity is measured by electrocardiography, not radiographs.