NR 328 EXAM QUESTIONS AND ANSWERS A+
GRADED .Buy Quality Materials!
What are the 2 major groups of cardiac disorders?
1. Congenital heart disease (anatomic abnormalities, present at birth)
2. Acquired cardiac disorders (infection, autoimmune response, environmental factors)
When does the patent ductus arteriosis begin to close?
The patent ductus arteriosus (PDA) starts to close within the first day after birth by
constriction of smooth muscle in the vessel.
Pediatric indicators of cardiac dysfunction
-Poor feeding
-Tachypnea & tachycardia
-FTT, poor weight gain, activity intolerance
-Developmental delays
-Prenatal hx
-Family hx of cardiac disease
What are positive prenatal indicators of cardiac dysfunction?
-Maternal chronic health conditions (DM & Lupus)
-Maternal med use (Dilantin, alcohol, drug use)
-Maternal exposure to infection (rubella)
-Family hx of heart defect
Indicators of cardiac dysfunction upon inspection
-FTT or poor weight gain
-Cyanosis and palor
-Chest deformities d/t enlarged heart
-Visible pulsations of neck veins
-Ease or difficulty of respiration
-Clubbing of fingers
What assessment tool is an indicator of impending CHF?
-Weight
What is often the 1st indicator of heart defect?
Presence of a heart murmur
Where should we take BP in infants/children suspected of having cardiovascular
dysfunction?
Take BP in ALL 4 extremities (lower extremities SHOULD BE 10-20mmHg higher than
upper extremities)
Diagnostic evaluation for cardiac dysfunction
Chest x-ray
Echocardiography
EKG
Important things to consider prior to cardiac catheterization
-Allergies (esp. in parents)
-Accurate height and weight (for catheter size)
-Diaper rash/hx of infection/fever (may cancel test)
, -Prepare child for procedure
-Baseline vitals and pulses (mark the pedal pulses PRIOR)
Cardiac catheterization sites for infants/children
-Femoral vein (for right side of heart)
-Femoral artery (for left side of heart)
Postprocedural care for cardiac catheterization
-Cardiac and pulse oximetry monitoring
-Monitor pulses, temp, and color of extremity
-Vital signs q15
-I&O
-Pain assessment (NSAIDs or acetaminophen)
-Monitor dressing for bleeding
What do you do if bleeding occurs at the insertion site after a cardiac
catheterization?
-Apply direct continuous pressure about 1 inch (2.5cm) above insertion site to localize
pressure over the vessel puncture
-Call HCP immediately
What are clinical consequences of congenital heart defects?
-Volume overload
-Pressure overload
-Decreased contractility
-High cardiac output demands
-Right-sided HF usually starts first (reduced function)
-Left-sided heart failure (Inc. pressure, lung congestion)
What do children with HF have a higher risk of due to fluid accumulation in the
lungs?
Higher risk of upper respiratory infection
Clinical manifestations of HF in children
-Impaired myocardial function: tachycardia, fatigue, weakness, restlessness, pale/cool
extremities, decreased BP, decreased urine output
-Pulmonary congestion: tachypnea, dyspnea, respiratory distress, exercise intolerance,
cyanosis
-Systemic venous congestion: peripheral and periorbital edema, weight gain, ascites,
hepatomegaly, neck vein distention
Parent education for administering digoxin
Teach them how to draw it up (small amounts)
Give at the same time every day
If the child vomits or is ill and vomiting - DO NOT give another dose and call HCP
What electrolyte levels should be carefully monitored in a child with HF taking
digoxin? Why?
-A fall in the serum potassium level enhances the effects of digoxin, increasing the risk
of digoxin toxicity. Increased serum potassium levels diminish digoxin's effect.
What medications are used to improve cardiac function?
Digoxin
ACE inhibitors
Beta blockers
GRADED .Buy Quality Materials!
What are the 2 major groups of cardiac disorders?
1. Congenital heart disease (anatomic abnormalities, present at birth)
2. Acquired cardiac disorders (infection, autoimmune response, environmental factors)
When does the patent ductus arteriosis begin to close?
The patent ductus arteriosus (PDA) starts to close within the first day after birth by
constriction of smooth muscle in the vessel.
Pediatric indicators of cardiac dysfunction
-Poor feeding
-Tachypnea & tachycardia
-FTT, poor weight gain, activity intolerance
-Developmental delays
-Prenatal hx
-Family hx of cardiac disease
What are positive prenatal indicators of cardiac dysfunction?
-Maternal chronic health conditions (DM & Lupus)
-Maternal med use (Dilantin, alcohol, drug use)
-Maternal exposure to infection (rubella)
-Family hx of heart defect
Indicators of cardiac dysfunction upon inspection
-FTT or poor weight gain
-Cyanosis and palor
-Chest deformities d/t enlarged heart
-Visible pulsations of neck veins
-Ease or difficulty of respiration
-Clubbing of fingers
What assessment tool is an indicator of impending CHF?
-Weight
What is often the 1st indicator of heart defect?
Presence of a heart murmur
Where should we take BP in infants/children suspected of having cardiovascular
dysfunction?
Take BP in ALL 4 extremities (lower extremities SHOULD BE 10-20mmHg higher than
upper extremities)
Diagnostic evaluation for cardiac dysfunction
Chest x-ray
Echocardiography
EKG
Important things to consider prior to cardiac catheterization
-Allergies (esp. in parents)
-Accurate height and weight (for catheter size)
-Diaper rash/hx of infection/fever (may cancel test)
, -Prepare child for procedure
-Baseline vitals and pulses (mark the pedal pulses PRIOR)
Cardiac catheterization sites for infants/children
-Femoral vein (for right side of heart)
-Femoral artery (for left side of heart)
Postprocedural care for cardiac catheterization
-Cardiac and pulse oximetry monitoring
-Monitor pulses, temp, and color of extremity
-Vital signs q15
-I&O
-Pain assessment (NSAIDs or acetaminophen)
-Monitor dressing for bleeding
What do you do if bleeding occurs at the insertion site after a cardiac
catheterization?
-Apply direct continuous pressure about 1 inch (2.5cm) above insertion site to localize
pressure over the vessel puncture
-Call HCP immediately
What are clinical consequences of congenital heart defects?
-Volume overload
-Pressure overload
-Decreased contractility
-High cardiac output demands
-Right-sided HF usually starts first (reduced function)
-Left-sided heart failure (Inc. pressure, lung congestion)
What do children with HF have a higher risk of due to fluid accumulation in the
lungs?
Higher risk of upper respiratory infection
Clinical manifestations of HF in children
-Impaired myocardial function: tachycardia, fatigue, weakness, restlessness, pale/cool
extremities, decreased BP, decreased urine output
-Pulmonary congestion: tachypnea, dyspnea, respiratory distress, exercise intolerance,
cyanosis
-Systemic venous congestion: peripheral and periorbital edema, weight gain, ascites,
hepatomegaly, neck vein distention
Parent education for administering digoxin
Teach them how to draw it up (small amounts)
Give at the same time every day
If the child vomits or is ill and vomiting - DO NOT give another dose and call HCP
What electrolyte levels should be carefully monitored in a child with HF taking
digoxin? Why?
-A fall in the serum potassium level enhances the effects of digoxin, increasing the risk
of digoxin toxicity. Increased serum potassium levels diminish digoxin's effect.
What medications are used to improve cardiac function?
Digoxin
ACE inhibitors
Beta blockers
