Pediatric Cardiac Review Examination

Exam 1 Pediatric Cardiac Review A 10-year-old child is recovering from a severe sore throat. The parent states that the child complains of chest pain. The nurse observes that the child has swollen joints, nodules on the fingers, and a rash on the chest. The likely cause is: a. Infective Endocarditis b. Rheumatic Fever c. Scarlet Fever d. Rheumatoid Arthritis - Answer- B To make the diagnosis of RF, major and minor criteria are used. Major criteria include carditis, subcutaneous nodules, erythema marginatum, chorea, and arthritis. Minor criteria include fever and previous history of RF. A 10-year-old has undergone a cardiac catheterization. At the end of the procedure, the nurse should first assess: 1. Pain. 2. Pulses. 3. Hemoglobin and hematocrit levels. 4. Catheterization report. - Answer- 2 Checking for pulses, especially in the canulated extremity, would assure perfusion to that extremity and is the priority post procedure. A 16-year-old being treated for hypertension has laboratory values of hemoglobin B 16 g/dL, hematocrit level 43%, sodium 139 mEq/L, potassium 4.4 mEq/L, and total cholesterol of 220 mg/dL. Which drug does the nurse suspect the patient takes based on the total cholesterol? 1. Beta blockers. 2. Calcium channel blockers. 3. ACE inhibitors. 4. Diuretics. - Answer- 1 Beta blockers are used with caution in patients with hyperlipidemia, hyperglycemia, and impotence. A 3-month-old has been diagnosed with a ventricular septal defect (VSD). The flow of blood through the heart is _____________________. a. Left to right b. Right to left c. Up to down d. Down to up - Answer- A The pressures in the left side of the heart are greater, causing the flow of blood to be from an area of higher pressure to lower pressure, or left to right, increasing the pulmonary blood flow with the extra blood A 6-month-old who has episodes of cyanosis after crying could have the congenital heart defect (CHD) of decreased pulmonary blood flow called _____________________. a. Tricuspid Atresia b. Tetralogy of Fallot c. Hypoplastic Left Heart Syndrome d. Ventricular Septal Defect - Answer- B A child born with Down syndrome should be evaluated for which associated cardiac manifestation? 1. Congenital heart defect (CHD). 2. Systemic hypertension. 3. Hyperlipidemia. 4. Cardiomyopathy. - Answer- 1 A child diagnosed with congestive heart failure (CHF) is receiving maintenance doses of digoxin and furosemide. She is rubbing her eyes when she is looking at the lights in the room, and her HR is 70 beats per minute. The nurse expects which laboratory finding? 1. Hypokalemia. 2. Hypomagnesemia. 3. Hypocalcemia. 4. Hypophosphatemia. - Answer- 1 The rubbing of the child's eyes may mean that she is seeing halos around the lights, indicating digoxin toxicity. The HR is slow for her age and also indicates digoxin toxicity. A decrease in serum potassium because of the furosemide can increase the risk for digoxin toxicity A child has a Glasgow Coma Scale of 3, HR of 88 beats per minute and regular, respiratory rate of 22, BP of 78/52, and blood sugar of 35 mg/dL. The nurse asks the caregiver about accidental ingestion of which drug? 1. Calcium channel blocker. 2. Beta blocker. 3. ACE inhibiter. 4. ARB. - Answer- 2