Nursing Care of the Child With an Alteration in
Perfusion/Cardiovascular Disorder, Nursing Care
of the Child with a Cardiovascular Disorder - Q&A
Save
Terms in this set (133)
The pediatric nurse has digoxin • 5-year-old child who developed vomiting and
ordered for each of five children. The diarrhea, and is difficult to arouse
nurse should withhold digoxin for • 16-year-old child with a heart rate of 54 beats per
which children? minute
• 2-year-old child whose digoxin level was 2.4 ng/mL
from a blood draw this morning
The nurse should not administer digoxin to children
with the following issues: The adolescent with an
apical pulse under 60 beats per minute, the child with
a digoxin level above 2 ng/mL, and the child who
exhibiting signs of digoxin toxicity.
Which nursing diagnosis would best Activity intolerance related to inability of heart to
apply to a child with rheumatic fever? sustain extra workload
Children with rheumatic fever need to reduce activity
to relieve stress during the course of the illness
,The nurse is caring for a child with • "Cardiac problems cause the heart to not pump
heart failure related to a congenital effectively, which causes swelling in the body and
heart defect. One of the nursing fluid in the lungs."
diagnoses identified includes "Excess
fluid volume." During a family care This response best explains the meaning of the
planning conference. the parents ask nursing diagnosis and it's cause. Although there are
why this diagnosis applies to their standardized care plans as a guide, each care plan
child. What is the best response by the must be individualized to the client. Stating, "The
nurse? heart is a pump and it isn't pumping effectively" does
not explain the nursing diagnosis. Telling the parents
not to worry does not help in educating them.
The parents of a 5-year-old child with "It's great you are providing nutritious meals, but
a cardiovascular disorder tell the smaller frequent meals will tire your child less and
nurse they don't understand why their promote weight gain."
child isn't gaining weight, "We make
sure our child has 3 very nutritious Small, frequent feedings will reduce the amount of
meals every day." How should the energy required to feed or eat and prevents
nurse respond? overtiring the child. Questioning if the parents are
making nutritious foods or foods the child likes does
not address the issue of energy expenditure when
eating 3 larger meals per day. Just stating that it is
"hard to get your child to eat enough" also does not
address the situation
A child with a congenital heart defect This is a test that will check how blood is flowing
is getting an echocardiogram. How through the heart.
would the nurse describe this test to
the parent? Echocardiograms can determine the size of the heart
and how the heart is pumping blood. An
echocardiogram does not check the electrical
impulses or the size of the heart. This is a non-invasive
test.
,The nurse is caring for a 7-year-old • "We know how important our child's medications are
who is being discharged following so we will write out a schedule to be sure
surgery with a Gore® Helex device to medications are taken as prescribed."
repair an atrial septal defect. The • "We will be sure to monitor our child for any signs of
parents of the child demonstrate infection and notify the doctor if we notice any."
understanding of the procedure with • "We will be sure to not allow our child to ride a
which statements? bicycle for at least 2 weeks."
With the Gore® Helex device, strenuous activity
should be avoided for 2 weeks after the procedure,
so neither soccer or bicycle riding would be allowed.
Children should be monitored for the possible
presence of atrial arrhythmias (lifelong) after surgical
closure for the defect. Infection is a complication that
must be monitored for and reported to the physician,
and medications must be given as prescribe
The nurse is caring for an infant with "While it seems that oxygen would help, it actually
Down syndrome who has been worsens this condition. Treating the cause of the
diagnosed with atrioventricular canal disease will help."
defect. The parents ask the nurse,
"Why do you not put oxygen on our For children with congenital defects with increased
baby more often when his lips and pulmonary blood flow, oxygen supplementation is
fingernails are blue?" What is the best not helpful. Oxygen acts as a pulmonary vasodilator.
response by the the nurse? If pulmonary dilation occurs, pulmonary blood flow
is even greater, causing tachypnea, increasing lung
fluid retention, and eventually causing a much
greater problem with oxygenation; therefore,
preventing the development of pulmonary disease
via early surgical correction is essential. Although
oxygen must be ordered by the physician and it isn't
the best treatment, the nurse stating, "While it seems
that oxygen would help, it actually makes the
condition worse. Treating the cause of the disease
will help" best answers the question while also
showing empathy.
, The nurse is caring for a pediatric Your child's body is trying to compensate for the low
client diagnosed with tetralogy of blood oxygen levels from the heart defect by making
Fallot. After speaking with the more red blood cells, but this makes the heart
physician, the parents state to the actually work harder."
nurse, "The doctor said something
about our child having too many red To compensate for low blood oxygen levels, the
blood cells. We don't understand how kidneys produce the hormone erythropoietin to
that could happen?" What is the best stimulate the bone marrow to produce more red
response by the nurse? blood cells (RBCs). This increase in RBCs is called
polycythemia. Polycythemia can lead to an increase
in blood volume and possibly blood viscosity, further
taxing the workload of the heart. The correct
response is the clearest and easiest description for
the parents to understand. Telling the parents the
doctor was discussing polycythemia with them
doesn't answer their question.
The nurse is assessing a child with a B. Decreased Contractility
cardiac problem. The child's Decreased contractility is suspected if the extremities
extremities are cool with thready are cool with thready pulses and urinary output is
pulses, and urinary output is diminished. Certain states (e.g., hypoxia, acidosis) are
diminished. This is most suggestive of known to depress contractility. Increased blood
which of the following? pressure is indicative of higher afterload. Increased
A. Increased afterload stroke volume and decreased cardiac output will not
B. Decreased contractility produce the symptoms described.
C. Increased stroke volume
D. Decreased cardiac output
Which of the following procedures Echocardiography
uses high-frequency sound waves Echocardiography uses high-frequency sound waves.
obtained by a transducer to produce The child must lie completely still. With the
an image of cardiac structures? improvements in technology, diagnosis can
A. Echocardiography sometimes be made without cardiac catheterization.
B. Electrophysiology Electrophysiology is an invasive procedure in which
C. Electrocardiography catheters with electrodes are used to record the
D. Cardiac catheterization impulses of the heart directly from the conduction
system. Electrocardiography is a tracing of the
electrical path of the depolarization action of
myocardial cells. Cardiac catheterization is an
invasive procedure in which a catheter is threaded
into the heart.
Perfusion/Cardiovascular Disorder, Nursing Care
of the Child with a Cardiovascular Disorder - Q&A
Save
Terms in this set (133)
The pediatric nurse has digoxin • 5-year-old child who developed vomiting and
ordered for each of five children. The diarrhea, and is difficult to arouse
nurse should withhold digoxin for • 16-year-old child with a heart rate of 54 beats per
which children? minute
• 2-year-old child whose digoxin level was 2.4 ng/mL
from a blood draw this morning
The nurse should not administer digoxin to children
with the following issues: The adolescent with an
apical pulse under 60 beats per minute, the child with
a digoxin level above 2 ng/mL, and the child who
exhibiting signs of digoxin toxicity.
Which nursing diagnosis would best Activity intolerance related to inability of heart to
apply to a child with rheumatic fever? sustain extra workload
Children with rheumatic fever need to reduce activity
to relieve stress during the course of the illness
,The nurse is caring for a child with • "Cardiac problems cause the heart to not pump
heart failure related to a congenital effectively, which causes swelling in the body and
heart defect. One of the nursing fluid in the lungs."
diagnoses identified includes "Excess
fluid volume." During a family care This response best explains the meaning of the
planning conference. the parents ask nursing diagnosis and it's cause. Although there are
why this diagnosis applies to their standardized care plans as a guide, each care plan
child. What is the best response by the must be individualized to the client. Stating, "The
nurse? heart is a pump and it isn't pumping effectively" does
not explain the nursing diagnosis. Telling the parents
not to worry does not help in educating them.
The parents of a 5-year-old child with "It's great you are providing nutritious meals, but
a cardiovascular disorder tell the smaller frequent meals will tire your child less and
nurse they don't understand why their promote weight gain."
child isn't gaining weight, "We make
sure our child has 3 very nutritious Small, frequent feedings will reduce the amount of
meals every day." How should the energy required to feed or eat and prevents
nurse respond? overtiring the child. Questioning if the parents are
making nutritious foods or foods the child likes does
not address the issue of energy expenditure when
eating 3 larger meals per day. Just stating that it is
"hard to get your child to eat enough" also does not
address the situation
A child with a congenital heart defect This is a test that will check how blood is flowing
is getting an echocardiogram. How through the heart.
would the nurse describe this test to
the parent? Echocardiograms can determine the size of the heart
and how the heart is pumping blood. An
echocardiogram does not check the electrical
impulses or the size of the heart. This is a non-invasive
test.
,The nurse is caring for a 7-year-old • "We know how important our child's medications are
who is being discharged following so we will write out a schedule to be sure
surgery with a Gore® Helex device to medications are taken as prescribed."
repair an atrial septal defect. The • "We will be sure to monitor our child for any signs of
parents of the child demonstrate infection and notify the doctor if we notice any."
understanding of the procedure with • "We will be sure to not allow our child to ride a
which statements? bicycle for at least 2 weeks."
With the Gore® Helex device, strenuous activity
should be avoided for 2 weeks after the procedure,
so neither soccer or bicycle riding would be allowed.
Children should be monitored for the possible
presence of atrial arrhythmias (lifelong) after surgical
closure for the defect. Infection is a complication that
must be monitored for and reported to the physician,
and medications must be given as prescribe
The nurse is caring for an infant with "While it seems that oxygen would help, it actually
Down syndrome who has been worsens this condition. Treating the cause of the
diagnosed with atrioventricular canal disease will help."
defect. The parents ask the nurse,
"Why do you not put oxygen on our For children with congenital defects with increased
baby more often when his lips and pulmonary blood flow, oxygen supplementation is
fingernails are blue?" What is the best not helpful. Oxygen acts as a pulmonary vasodilator.
response by the the nurse? If pulmonary dilation occurs, pulmonary blood flow
is even greater, causing tachypnea, increasing lung
fluid retention, and eventually causing a much
greater problem with oxygenation; therefore,
preventing the development of pulmonary disease
via early surgical correction is essential. Although
oxygen must be ordered by the physician and it isn't
the best treatment, the nurse stating, "While it seems
that oxygen would help, it actually makes the
condition worse. Treating the cause of the disease
will help" best answers the question while also
showing empathy.
, The nurse is caring for a pediatric Your child's body is trying to compensate for the low
client diagnosed with tetralogy of blood oxygen levels from the heart defect by making
Fallot. After speaking with the more red blood cells, but this makes the heart
physician, the parents state to the actually work harder."
nurse, "The doctor said something
about our child having too many red To compensate for low blood oxygen levels, the
blood cells. We don't understand how kidneys produce the hormone erythropoietin to
that could happen?" What is the best stimulate the bone marrow to produce more red
response by the nurse? blood cells (RBCs). This increase in RBCs is called
polycythemia. Polycythemia can lead to an increase
in blood volume and possibly blood viscosity, further
taxing the workload of the heart. The correct
response is the clearest and easiest description for
the parents to understand. Telling the parents the
doctor was discussing polycythemia with them
doesn't answer their question.
The nurse is assessing a child with a B. Decreased Contractility
cardiac problem. The child's Decreased contractility is suspected if the extremities
extremities are cool with thready are cool with thready pulses and urinary output is
pulses, and urinary output is diminished. Certain states (e.g., hypoxia, acidosis) are
diminished. This is most suggestive of known to depress contractility. Increased blood
which of the following? pressure is indicative of higher afterload. Increased
A. Increased afterload stroke volume and decreased cardiac output will not
B. Decreased contractility produce the symptoms described.
C. Increased stroke volume
D. Decreased cardiac output
Which of the following procedures Echocardiography
uses high-frequency sound waves Echocardiography uses high-frequency sound waves.
obtained by a transducer to produce The child must lie completely still. With the
an image of cardiac structures? improvements in technology, diagnosis can
A. Echocardiography sometimes be made without cardiac catheterization.
B. Electrophysiology Electrophysiology is an invasive procedure in which
C. Electrocardiography catheters with electrodes are used to record the
D. Cardiac catheterization impulses of the heart directly from the conduction
system. Electrocardiography is a tracing of the
electrical path of the depolarization action of
myocardial cells. Cardiac catheterization is an
invasive procedure in which a catheter is threaded
into the heart.
