Congenital Heart Defects Exam | Complete Solutions (Verified)

Congenital Heart Defects Exam | Complete Solutions (Verified) A nurse is caring for an infant who just had open-heart surgery and the parents are asking why there are wires coming out of the infant's chest. What is the best response by the nurse? A) These wires are connected to the heart and will detect if your infant's heart gets out of rhythm. B)The wires are measuring the fluid level in the heart. C) The wires are left in the heart for 1 month after surgery in case needed for potential arrhythmias. D) The wires will administer ongoing electrical shocks to the heart to maintain rhythm. A nurse is reviewing blood work for a child with a cyanotic heart defect. What result would most likely be seen in a client experiencing polycythemia? A) Increased WBC B) Decreased RBC C) Decreased WBC D) Increased RBC The nurse is caring for a 5-year-old child with a congenital heart anomaly causing chronic cyanosis. When performing the history and physical examination, what is the nurse least likely to assess? A) Obesity from overeating B) Clubbing of the nail beds C) Squatting during play activities D) Exercise intolerance A 2-day-old infant was just diagnosed with pulmonic stenosis. What is the most likely nursing assessment finding? A) Gallop and rales B) Blood pressure discrepancies in the extremities C) Right ventricular hypertrophy on ECG D) Heart murmur An infant with tetralogy of Fallot becomes cyanotic. Which nursing intervention would be the first priority? A) Place the infant in the knee-chest position. B) Start an IV for fluids. C) Prepare the infant for surgery. D) Raise the head of the bed. A nurse suspects a child is experiencing cardiac tamponade after heart surgery. What would be the priority nursing intervention? A) Elevate the head of the bed. B) Notify the doctor immediately. C) Administer epinephrine. D) Observe vitals every two hours. A mother asks why her infant with a cyanotic heart defect turns blue. What is the best response by the nurse? A) This is due to the lack of oxygen to the brain. B) This is due to a decreased amount of oxygen to the peripheral tissue. C) This is a sign of heart failure. D) This is considered a medical emergency and needs immediate surgery. The nurse is caring for a 3-month-old infant with history of congenital heart disease. The infant is brought to the emergency department with nausea and vomiting for 3 days. Admission laboratory results confirm dehydration. The nurse realizes that the dehydrated infant is at risk for: A) Seizure activity. B) Tachycardia. C) A cerebrovascular accident. D) Jaundice. Children who have defects which cause a decreased pulmonary blood flow have decreased oxygen saturation. To compensate the kidneys produce erythropoiten to stimulate the bone marrow to make more red blood cells. The increased red blood cells makes the blood more viscous. If an infant with heart disease becomes dehydrated the infant can develop thrombi from the increased amounts of red blood cells and the viscosity of the blood. This places the infant at risk for a cerebrovascular event. The nurse is caring for a 7-year-old who is being discharged following surgery with a Gore® Helex device to repair an atrial septal defect. The parents of the child demonstrate understanding of the procedure with which statements? Select all that apply. A) "Our child will be so excited to get back to soccer league in a few days." B) "We will be sure to not allow our child to ride a bicycle for at least 2 weeks." C) "It's wonderful that our child will never have an abnormal heart rhythm again." D) "We will be sure to monitor our child for any signs of infection and notify the doctor if we notice any." E) "We know how important our child's medications are so we will write out a schedule to be sure medications are taken as prescribed." The nurse is providing child and family education prior to discharge following a cardiac catheterization. The nurse is teaching about signs and symptoms of complications. Which statement by the mother indicates a need for further teaching? A) "The feeling of the heart skipping a beat is common." B) "We need to avoid a tub bath for the next 3 days." C) "Strenuous activity should be limited for the next 3 days." D) "We need to watch for changes in skin color or difficulty breathing." After assessing a child, the nurse suspects coarctation of the aorta based on a finding of: A) Femoral pulse weaker than brachial pulse. B) Bounding pulse. C) Narrow pulse. D) Hepatomegaly. The nurse is caring for a pediatric client diagnosed with tetralogy of Fallot. After speaking with the physician, the parents state to the nurse, "The doctor said something about our child having too many red blood cells. We don't understand how that could happen?" What is the best response by the nurse? A) "The doctor was talking about polycythemia. It's common with this type of heart disorder." B) "It is a very complicated process. Since your child has tetralogy of Fallot, their body is overtaxed with everything it does. The amount of red blood cells being produced is just one more thing the heart has to deal with." C) "Your child's body is trying to compensate for the low blood oxygen levels from the heart defect by making more red blood cells, but this makes the heart actually work harder." D) "I'm not really sure what red blood cells have to do with the heart defect your child has. We should ask your doctor." A parent is asking for more information about their infant's patent ductus arteriosus (PDA). What would be included in the education? A) Your child may need multiple surgeries to correct this defect. B) An IV for fluids will be started immediately. C) This is caused by an opening that usually closes by 1 week of age. D) This type of defect is caused by having a genetic predisposition for it. A 6-year-old girl is diagnosed with pulmonary stenosis. The mother asks the nurse what the likely treatment for this condition will involve. What should the nurse tell the mother? A) Insertion of a catheter with an uninflated balloon tip into the affected valve, followed by inflation of the balloon to break up adhesions B) No treatment is necessary, as the defect will resolve spontaneously C) Insertion of Dacron-coated stainless-steel coils by interventional cardiac catheterization D) Surgical closure by ductal ligation The nurse is caring for an 8-month-old infant with a suspected congenital heart defect. The nurse examines the child and documents which expected finding? A) Steady weight gain since birth B) Softening of the nail beds C) Appropriate mastery of developmental milestones D) Intact rooting reflex The nurse is caring for an infant with Down syndrome who has been diagnosed with atrioventricular canal defect. The parents ask the nurse, "Why do you not put oxygen on our baby more often when his lips and fingernails are blue?" What is the best response by the the nurse? A) "I can only place oxygen on your child if the doctor orders oxygen." B) "Oxygen isn't always the best treatment for your child's condition. Surgery is necessary." C) "This is something we should talk with the physician about. Maybe it would help your baby." D) "While it seems that oxygen would help, it actually worsens this condition. Treating the cause of the disease will help." When caring for a child with a congenital heart defect, which assessment finding may be a sign the child is experiencing heart failure? A) Tachycardia B) Bradycardia C) Inability to sweat D) Splenomegaly A nurse is providing education to a family about cardiac catheterization. What information would be included in the education? A) The catheter will be placed in the femoral artery. B) The catheter will be placed in the brachial artery. C) The child will be able to move the leg again immediately after the procedure. D) The procedure will be performed even if the child has a fever. A nurse is interviewing a mother who is about to give birth. Which response would alert the nurse for a higher potential for a heart defect in the newborn? A) The mother states she has lupus. B) The mother states she took acetaminophen while pregnant. C) The mother has seizures, but did not take medication while pregnant. D) The mother states she slept all the time while pregnant. An infant with poor feeding is suspected of having a congenital heart defect. The parents are asking why a chest x-ray is necessary in their infant. What is the best response from the nurse? A) It will determine if the heart is enlarged. B) It will determine disturbances in heart conduction. C) It will show if blood is being shunted. D) This image will clarify the structures within the heart. When reviewing the record of a child with tetralogy of Fallot, what would the nurse expect to discover? A) Leukopenia B) Polycythemia C) Increased platelet level D) Anemia An 8-month-old infant has a ventricular septal defect. Which nursing diagnosis would best apply? A) Ineffective airway clearance related to altered pulmonary status B) Ineffective tissue perfusion related to inefficiency of the heart as a pump C) Impaired gas exchange related to a right-to-left shunt D) Impaired skin integrity related to poor peripheral circulation A newborn has been diagnosed with a congenital heart disease. Which congenital heart disease is associated with cyanosis? A) Coarctation of aorta B) Tetralogy of Fallot C) Pulmonary stenosis D) Aortic stenosis A 5-year-old is being prepared for diagnostic cardiac catheterization, in which the catheter will be inserted in the right femoral vein. What intervention should the nurse take to prevent infection? A) Keep the child NPO for 2 to 4 hours before the procedure B) Record pedal pulses C) Avoid drawing a blood specimen from the right femoral vein before the procedure D) Apply EMLA cream to the catheter insertion site The nurse in a pediatric cardiovascular clinic is talking with the father of a 5-year-old child who underwent cardiac surgery for a heart defect at the age of 3. The father reports that the child has been having increased shortness of breath, tires easily after playing, and has been gaining weight. The nurse is aware that the child is most likely demonstrating symptoms of which acquired cardiovascular disorder? A) Heart failure B) Infective endocarditis C) Cardiomyopathy D) Kawasaki Disease A child will be undergoing a Holter monitor test. Which statement by the mother indicates the need for further instruction? A) "Wearing a snug shirt the day of the test will be helpful." B) "My child cannot have any thing to eat or drink after midnight the day of the test." C) "This test will monitor my child for about 24 hours." D) "We do not need to alter our activities during the testing period." Holter monitor test is a battery-operated portable device that measures and records your heart's activity (ECG) continuously for 24 to 48 hours or longer depending on the type of monitoring used A child with a congenital heart defect is getting an echocardiogram. How would the nurse describe this test to the parent? A) This test that check how blood is flowing through the heart. B) This noninvassive test will check the electrical impulses in the heart. C) This test will only determine the size of the heart. D) This invasive test will measure the blockage in the heart. When educating the family of an infant with a small, asymptomatic atrial septal defect (ASD), what information would be included in the education? A) "Surgery is usually performed in the first two months of life for this." B) "Most infants do not need surgical repair for this." C) "The medication indomethacin is used to try to close the hole." D) "The medication prostaglandin E1 is used to try to close the hole." A parent is told their infant has a heart defect with a left to right shunt. What is the best way for the nurse to explain this type of shunting to the parent? A) This type of shunting causes an increase of blood to the lungs. B) This type of shunting causes an increase of blood to the systemic circulation. C) This type of shunting causes a decrease of blood to the lungs. D) This type of shunting causes a decrease of blood to the brain.