NUR 257 Exam 3- Peters study guide
What is the problem w/ PDA? - answer-Patent Ductus Arterioles (artery connecting
aorta and pulmonary artery)
-Increased pulmonary blood flow, blood doesn't get to rest of body well
-Does not close at birth (usually does)
-Wide pulse pressure
What would be the expected goal/outcome if PDA is surgically repaired? - answer-Clip
off ductus preventing return blood flow to lungs
-Increase blood flow to body
-Indocin = medication that promotes closure
What assessment findings would the nurse anticipate finding in an infant with
coarctation of aorta? - answer-narrowing of aorta
-Increased BP in upper extremities
-Nosebleeds
-Weak or absent lower extremity pulses
-Cool lower extremities
What are the 4 problems in a child with Tetralogy of Fallot? - answer-VSD = ventricular
septal defects - hole in heart
-Overriding aorta (part opens in RV), aorta in wrong spot
-R ventricular hypertrophy - enlargement of cardiac muscle
-Pulmonic stenosis - narrowing of pulmonary artery
-------Murmur
-------Cyanotic
-------Dyspnea
-------Polycythhemia
What instructions should the nurse provide parents who are having to administer
Digoxin to their child? - answer- BP and anti-arrhythmic
-Very narrow therapeutic range
-Do not administer if HR below 90 in infants and below 70 in children
-Nurse watches parent measure the elixir in the dropper and stresses the level mark as
the meniscus of the fluid that is observed at eye level
-Signs of dig toxicity: yellow vision, N/V, diarrhea, leads to dehydration
-Same time every day and twice a day
Purpose of administration of Lasix (Furosemide) to kids w/ CHF - answer-Remove
accumulated fluid and sodium
-Strict I/O
, What are the benefits of supplementally feeding an infant with CHF tube feedings? -
answer-Small frequent feedings to help decrease oxygenation consumption
-Monitors intake more strictly
-Control calories to help with growth and development
-Can monitor fluid
-Not having to work for calories
what all is involved in the nursing care of the infant/child with CHF? - answer-Improve
cardiac function/output
Digoxin
-Remove accumulated fluid and sodium
Diuretics
May have sodium and water
restrictions
-Decrease cardiac demands
Limit activity
Maintain body temperature
Position to decrease effort
of breathing
Sedate if irritable
-Improve tissue oxygenation
Provide cool, humidified
oxygen
-Decrease oxygenation consumption
Gavage (tube) feedings
What are some maternal risk factors to the development of congenital heart defects? -
answer-Chronic health conditions (DM, poorly controlled PKU)
-Maternal alcohol/illicit drug use
-Teratogenic medications
-Exposure to infections (rubella*)
-Exposure to environmental toxins
-Low birth weight d/t intrauterine growth restriction
-High birth weight infants
Treatment/care of the child experiencing a vaso-occlusive sickle cell crisis? - answer-
Hydration and oxygen*
-PCA opioids around the clock (not ASA, acetamin, Demerol)
-Rest
-Heating pad to affected joints
-Possible blood transfusions
-I/O
-Passive ROM
-high calorie/high protein diet when tolerated
-ATB prophylactically
-Flu, pneumonia, meningococcal vaccines
What is the problem w/ PDA? - answer-Patent Ductus Arterioles (artery connecting
aorta and pulmonary artery)
-Increased pulmonary blood flow, blood doesn't get to rest of body well
-Does not close at birth (usually does)
-Wide pulse pressure
What would be the expected goal/outcome if PDA is surgically repaired? - answer-Clip
off ductus preventing return blood flow to lungs
-Increase blood flow to body
-Indocin = medication that promotes closure
What assessment findings would the nurse anticipate finding in an infant with
coarctation of aorta? - answer-narrowing of aorta
-Increased BP in upper extremities
-Nosebleeds
-Weak or absent lower extremity pulses
-Cool lower extremities
What are the 4 problems in a child with Tetralogy of Fallot? - answer-VSD = ventricular
septal defects - hole in heart
-Overriding aorta (part opens in RV), aorta in wrong spot
-R ventricular hypertrophy - enlargement of cardiac muscle
-Pulmonic stenosis - narrowing of pulmonary artery
-------Murmur
-------Cyanotic
-------Dyspnea
-------Polycythhemia
What instructions should the nurse provide parents who are having to administer
Digoxin to their child? - answer- BP and anti-arrhythmic
-Very narrow therapeutic range
-Do not administer if HR below 90 in infants and below 70 in children
-Nurse watches parent measure the elixir in the dropper and stresses the level mark as
the meniscus of the fluid that is observed at eye level
-Signs of dig toxicity: yellow vision, N/V, diarrhea, leads to dehydration
-Same time every day and twice a day
Purpose of administration of Lasix (Furosemide) to kids w/ CHF - answer-Remove
accumulated fluid and sodium
-Strict I/O
, What are the benefits of supplementally feeding an infant with CHF tube feedings? -
answer-Small frequent feedings to help decrease oxygenation consumption
-Monitors intake more strictly
-Control calories to help with growth and development
-Can monitor fluid
-Not having to work for calories
what all is involved in the nursing care of the infant/child with CHF? - answer-Improve
cardiac function/output
Digoxin
-Remove accumulated fluid and sodium
Diuretics
May have sodium and water
restrictions
-Decrease cardiac demands
Limit activity
Maintain body temperature
Position to decrease effort
of breathing
Sedate if irritable
-Improve tissue oxygenation
Provide cool, humidified
oxygen
-Decrease oxygenation consumption
Gavage (tube) feedings
What are some maternal risk factors to the development of congenital heart defects? -
answer-Chronic health conditions (DM, poorly controlled PKU)
-Maternal alcohol/illicit drug use
-Teratogenic medications
-Exposure to infections (rubella*)
-Exposure to environmental toxins
-Low birth weight d/t intrauterine growth restriction
-High birth weight infants
Treatment/care of the child experiencing a vaso-occlusive sickle cell crisis? - answer-
Hydration and oxygen*
-PCA opioids around the clock (not ASA, acetamin, Demerol)
-Rest
-Heating pad to affected joints
-Possible blood transfusions
-I/O
-Passive ROM
-high calorie/high protein diet when tolerated
-ATB prophylactically
-Flu, pneumonia, meningococcal vaccines
