1 | P a g e EXAM ELABORATION FOR NUR 283 COMP MEDS 2024/2025 {GRADED A} QUESTIONS AND ANSWERS {100% CORRECT} LATEST UPDATE Patent Ductus Arteriosus (PDA) - CORRECT ANSWER S/S: Increased pulmonary flow machine like murmur breathing difficulty heart failure ductus remained open after birth Patent Ductus A rteriosus (PDA) - CORRECT ANSWER What do we do about it: Prostaglandin inhibitor (Indomethacin) or Ibuprofen first to close hole, then cath procedure to close off hole between pulmonary artery and aorta if medication did not work Patent Ductus Arterios us (PDA) - CORRECT ANSWER Nurse role: if needed cath procedure needed, post cath care if heart failure care appropriate for that (medications) Ventricular Septal Defect (VSD) - CORRECT ANSWER S/S: Increased pulmonary flow loud systolic murmur breath ing difficulty heart failure respiratory infections Ventricular Septal Defect (VSD) - CORRECT ANSWER What do we do about it: Cath procedure or open heart surgery to close off hole between the ventricles 2 | P a g e Ventricular Septal Defect (VSD) - CORRECT ANSWE R Nurse role: post cath care if heart failure care appropriate for that (medications) Coarctation of the Aorta - CORRECT ANSWER S/S: Strong pulse to upper body, Poor pedal pulses, cool/mottled feet (maybe dusky), decreased bowel sounds and poor feedi ng/poor weight gain Coarctation of the Aorta - CORRECT ANSWER What do we do about it: Cath to balloon/stent or thoracotomy approach procedure to repair with patch Coarctation of the Aorta - CORRECT ANSWER Nurse role: get a four extremity BP of ther e are clinical manifestations Surgery recovery (vitals, labs, urine output, etc) Tetralogy of Fallot - TOF - CORRECT ANSWER S/S: PROV -e, Pulmonary Stenosis, Right Ventricular Hypertrophy, Overriding Aorta, Ventricular Septal Defect, E - elevated H/H (polycythemia), cyanosis, Tetralogy of Fallot - TOF - CORRECT ANSWER What do we do about it: Surgery - balloon pulmonary stenosis and patch VSD, need to increase flow to pulmonary system 3 | P a g e Tetralogy of Fallot - TOF - CORRECT ANSWER Nurse role: manage heart failure, medication, cluster care, high calorie formula, small frequent meals . Manage hypercyanotic spells: knees to chest, oxygen, calm, morphine Sickle Cell - CORRECT ANSWER S/S: Acute vaso -occlusive crisis, spleen sequestration, acute chest syndrome Sickle Cell - CORRECT ANSWER What we do about it: Preventative education , Hydroxyurea, Penicillin, Folic Acid, Iron Chelation, blood transfusion or exchange, all immunizations, avoid triggers Sickle Cell - CORRECT ANSWER Nurse role: In a crisis -O2 if symptomatic, treat cause (infection, dehydration), Pain management, Fluid s, Heat, Rest Leukemia - CORRECT ANSWER S/S: Triad - anemia, thrombocytopenia, neutropenia, bone pain, weight loss, CNS involved? Leukemia - CORRECT ANSWER What we do about it: chemotherapy including intrathecal Leukemia - CORRECT ANSWER Nursin g management: Monitor labs and infection risk, oral care, MIVF 1.5? chemotherapy safety, no rectal temps, or live viral vaccines
