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Pediatric Cardiac Exam|
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A child diagnosed with tetralogy of fallot becomes upset, crying and thrashing
around when a blood specimen is obtained. The child's color becomes blue and
respiratory rate increases to 44 bpm. Which of the following actions would the
nurse do first?
a) obtain an order for sedation for the child
b) assess for an irregular heart rate and rhythm
c) explain to the child that it will only hurt for a short time
d) place the child in knee-to-chest position - correct answer✔️✔️Answer: D.
the child is experiencing a "tet spell" or hypoxic episode. Therefore the nurse
should place the child in a knee-to-chest position. Flexing the legs reduces venous
flow of blood from lower extremities and reduces the volume of blood being
shunted through the interventricular septal defect and the overriding aorta in the
child with tetralogy of fallot. As a result, the blood then entering the systemic
circulation has higher oxygen content, and dyspnea is reduced. Flexing the legs
also increases vascular resistance and pressure in the left ventricle. An infant
often assumes a knee-to-chest position to relieve dyspnea. If this position is
ineffective, then the child may need sedative. Once the child is in this position,
the nurse may assess for an irregular heart rate and rhythm. Explaining tho the
child that it will only hurt for a short time does nothing to alleviate hypoxia.
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The mother of a child with tetralogy of Fallot asks the nurse why her child has
clubbed fingers. The nurse bases the response on the understanding that clubbing
is due to which of the following?
a) Anemia.
b) Peripheral hypoxia.
c) Delayed physical growth.
d) Destruction of bone marrow. - correct answer✔️✔️Answer: B
Clubbing of the fingers is one common finding in the child with persistent hypoxia
leading to tissue changes in the body because of the low oxygen content of the
blood (hypoxemia). It apparently results from tissue fibrosis and hypertrophy
from the hypoxemia and from an increase in capillaries in the area, which occur as
the body attempts to improve blood supply. Clubbing of the fingers is associated
with polycythemia, not anemia. Polycythemia results from the body's attempt to
increase oxygen levels in the tissues. The child may be small for his or her
chronological age, but clubbing does not result from slow physical growth.
Destruction of the bone marrow is not related to this congenital heart
malformation. Instead, bone marrow is actively producing erythrocytes to
compensate for the chronic hypoxia.
A chest x-ray examination is ordered for a child with suspected cardiac problems.
The child's parent asks the nurse, "What will the x-ray show about the heart?"
The nurse's response should be based on knowledge that the x-ray film will do
which of the following?
a. Show bones of chest but not the heart
b. Evaluate the vascular anatomy outside of the heart
c. Show a graphic measure of electrical activity of the heart
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d. Provide information on heart size and pulmonary blood flow patterns - correct
answer✔️✔️ANS: D
Chest x-ray films provide information on the size of the heart and pulmonary
blood flow patterns. The bones of the chest are visible on the chest x-ray film, but
the heart and blood vessels are also seen. Magnetic resonance imaging is a
noninvasive technique that allows for evaluation of vascular anatomy outside of
the heart. A graphic measure of electrical activity of the heart is provided by
electrocardiography.
John is a 6-year-old child scheduled for a cardiac catheterization. Preoperative
teaching should be which of the following?
a. Directed at his parents because he is too young to understand
b. Adapted to his level of development so that he can understand
c. Done several days before the procedure so he will be prepared
d. Provide details about the actual procedures so he will know what to expect -
correct answer✔️✔️ANS: B
Preoperative teaching should always be directed to the child's stage of
development. The caregivers also benefit from these explanations. The parents
may ask additional questions, which should be answered, but the child needs to
receive the information based on developmental level. This age-group will not
understand in-depth descriptions. School-age children should be prepared close
to the time of the cardiac catheterization.
A nurse is preparing for the admission of a child with a diagnosis of acute-stage
Kawasaki disease. On assessment of the child, the nurse expects to note which
clinical manifestation of the acute stage of the disease?
a) cracked lips
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Pediatric Cardiac Exam|
complete study guide with
detailed questions and 100%
updated answers|Get a pass
A child diagnosed with tetralogy of fallot becomes upset, crying and thrashing
around when a blood specimen is obtained. The child's color becomes blue and
respiratory rate increases to 44 bpm. Which of the following actions would the
nurse do first?
a) obtain an order for sedation for the child
b) assess for an irregular heart rate and rhythm
c) explain to the child that it will only hurt for a short time
d) place the child in knee-to-chest position - correct answer✔️✔️Answer: D.
the child is experiencing a "tet spell" or hypoxic episode. Therefore the nurse
should place the child in a knee-to-chest position. Flexing the legs reduces venous
flow of blood from lower extremities and reduces the volume of blood being
shunted through the interventricular septal defect and the overriding aorta in the
child with tetralogy of fallot. As a result, the blood then entering the systemic
circulation has higher oxygen content, and dyspnea is reduced. Flexing the legs
also increases vascular resistance and pressure in the left ventricle. An infant
often assumes a knee-to-chest position to relieve dyspnea. If this position is
ineffective, then the child may need sedative. Once the child is in this position,
the nurse may assess for an irregular heart rate and rhythm. Explaining tho the
child that it will only hurt for a short time does nothing to alleviate hypoxia.
SUCCESS
,STUDYSAGE
The mother of a child with tetralogy of Fallot asks the nurse why her child has
clubbed fingers. The nurse bases the response on the understanding that clubbing
is due to which of the following?
a) Anemia.
b) Peripheral hypoxia.
c) Delayed physical growth.
d) Destruction of bone marrow. - correct answer✔️✔️Answer: B
Clubbing of the fingers is one common finding in the child with persistent hypoxia
leading to tissue changes in the body because of the low oxygen content of the
blood (hypoxemia). It apparently results from tissue fibrosis and hypertrophy
from the hypoxemia and from an increase in capillaries in the area, which occur as
the body attempts to improve blood supply. Clubbing of the fingers is associated
with polycythemia, not anemia. Polycythemia results from the body's attempt to
increase oxygen levels in the tissues. The child may be small for his or her
chronological age, but clubbing does not result from slow physical growth.
Destruction of the bone marrow is not related to this congenital heart
malformation. Instead, bone marrow is actively producing erythrocytes to
compensate for the chronic hypoxia.
A chest x-ray examination is ordered for a child with suspected cardiac problems.
The child's parent asks the nurse, "What will the x-ray show about the heart?"
The nurse's response should be based on knowledge that the x-ray film will do
which of the following?
a. Show bones of chest but not the heart
b. Evaluate the vascular anatomy outside of the heart
c. Show a graphic measure of electrical activity of the heart
SUCCESS
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d. Provide information on heart size and pulmonary blood flow patterns - correct
answer✔️✔️ANS: D
Chest x-ray films provide information on the size of the heart and pulmonary
blood flow patterns. The bones of the chest are visible on the chest x-ray film, but
the heart and blood vessels are also seen. Magnetic resonance imaging is a
noninvasive technique that allows for evaluation of vascular anatomy outside of
the heart. A graphic measure of electrical activity of the heart is provided by
electrocardiography.
John is a 6-year-old child scheduled for a cardiac catheterization. Preoperative
teaching should be which of the following?
a. Directed at his parents because he is too young to understand
b. Adapted to his level of development so that he can understand
c. Done several days before the procedure so he will be prepared
d. Provide details about the actual procedures so he will know what to expect -
correct answer✔️✔️ANS: B
Preoperative teaching should always be directed to the child's stage of
development. The caregivers also benefit from these explanations. The parents
may ask additional questions, which should be answered, but the child needs to
receive the information based on developmental level. This age-group will not
understand in-depth descriptions. School-age children should be prepared close
to the time of the cardiac catheterization.
A nurse is preparing for the admission of a child with a diagnosis of acute-stage
Kawasaki disease. On assessment of the child, the nurse expects to note which
clinical manifestation of the acute stage of the disease?
a) cracked lips
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