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Pediatric > Hay- Practice Questions- Test 2 > Flashcards

Hay- Practice Questions- Test 2 Flashcards

1
Q

A nurse is conducting a class for fetal circulation. What is an accurate statement about fetal circulation?

  1. O2 carried to. the fetus by umbilical arteries
  2. blood from the inferior vena cava is shunted to the rt ventricle through the foramen ovale
  3. Pulmo vascular resistance is high because lungs filled with blood
  4. blood flows from ductus arteriosus to the pulmo artery
A
  1. pulmonary resistance is high because the lungs are filled with blood
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2
Q

Fetal Circulation

A
  1. Resistance in the pulmonary circulation is high because the lungs are collapsed and filled with fluid
  2. O2 & nutrients are carried to the fetus by the umbilical vein
  3. The inferior vena cava empties blood into the rt atrium
  4. The direction of blood flow & pressure in the right atrium propel most of the blood through the foramen ovale into the left atrium.
  5. Most of the pulmonary blood in the pulmonary artery flows through the ductus arteriosus into the descending aorta
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3
Q

A nurse is preparing to assess a 9 month old infant for atrial septal defect (ASD). Which should the nurse do first for cardiac assessment

a. percussion
b palpation
c auscultation
d. history & inspection

A

history and inspection

Inspect
auscultate
palpate

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4
Q

What causes a risk for congenital heart defect?
a. trisomy 21 on amnio
b. family h/o MI
c. father type I DM
d. turners syndrome sibling

A

trisomy 21- 50% high with kids who have Down syndrome

infants born to mothers who have insulin resistance higher risk for congenital heart defect

identified turners syndrome CHD

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5
Q

CHF baby

A

weigh baby same time each day

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6
Q

The nurse is assessing a premature newborn infant auscultates a continuous machine like murmur. The finding is associated with what congenital heart defect?

a. pulmonary stenosis?
b. patient ductus arteriosus
c. ventricular septal defect
d. coarctation of the aorta

A

B. patent ductus arteriosus

This machine like murmur can be heard throughout systole & diastole

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7
Q

What heart condition has a murmur that has a systolic ejection murmur that is accompanied with a palpable thrill?
a. pulmonary stenosis?
b. patient ductus arteriosus
c. ventricular septal defect
d. coarctation of the aorta

A

a. pulmonary stenosis?

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8
Q

What is the characteristic murmur associated with ventricular septal defect?

A

loud harsh holosystolic murmur

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9
Q

What condition has a systolic murmur accompanied by an ejection click that can be heard on auscultation?

A

coarctation of the aorta

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10
Q

What is an expected assessment finding in a child with coarctation of the aorta?

a. orthostatic hypotension
b. systolic hypertension in the lower extremities
c. blood pressure higher on the left side of the body
d. disparity in blood pressure between the upper & lower extremities

A

d. disparity in blood pressure between the upper & lower extremities

Systolic HTN can be seen in the upper extremities

The left arm may not reflect systolic HTN because the left subclavian artery can be involved in coarctation

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11
Q

A nurse is assessing an infant with chronic hypoxia (not enough O2 in tissues) due to tetralogy of fallout. which finding does the nurse expect to assess?

a. polycythemia
b. pulmonary HTN
c. dehydration
d. anemia

A

Polycythemia

Increased RBCs in the blood- RBC’s carry O2- hypoxia the child needs O2

Why?
The body attempts to improve O2 by producing additional RBC’s & increases O2 carrying capacity of the blood.

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12
Q

What is a clinical consequence of pulmonary hypertension?

A

cyanosis

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13
Q

What can occur in cyanotic heart disease

A

dehydration because babies are too tired to eat

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14
Q

What may develop as a result of increased blood viscosity?

A

anemia

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15
Q

A child had a ventricular septal defect surgically repaired 3 months ago. Which antibiotic prophlaxis is indicated for the dental procedure?

A

amoxicillin taken orally 1 hour before the procedure

antibiotic prophylaxis 6 months after the procedure

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16
Q

what is the treatment for infective endocarditis?

A

parenteral antibiotics for 4-8 wks

17
Q

A nurse is assessing a 7 year old infant. The nurse detects a soft murmur. The nurse notified the primary care provider. The nurse is aware that fetal shunts close in an infant at what time?

a. when the umbilical cord is cut
b. within several days of birth
c. within a month after birth
d. by the end of the first year

A

B. within several days after birth

18
Q

In the normal neonate fetal shunts functionally close in response to?

A

pressure changes in the systemic & pulmonary circulations & to increased O2 content

The process may take several days to complete

19
Q

With the neonates first breath gas exchange is transferred from the ___ to the ___

A

placenta to the lungs

20
Q

True or false
the separation of the fetus from the umbilical cord does NOT contribute to the establishment of neonatal circulation?

A

True

21
Q

When assessing a child for congenital heart defects/ where should the nurse measure BP?
a. rt arm
b. left arm
c. all 4 extremities
d. both arms while the child is crying

A

c. all 4 extremities

22
Q

BPs when child is crying are likely to be

A

inaccurate & increased

23
Q

Discrepancies between upper & lower extremities may indicate

A

cardiac disease

24
Q

Blood pressure measurements for upper & lower extremities are compared during an assessment for

A

congenital heart defects

25
Q

A nurse is explaining a patent ductus arteriosus defect to the parents of a preterm infant. The parents indicate understanding of the defect when they state that a patent ductus arteriosus?

a. involves a defect that involves right to left shunting of the blood in the heart
b. involves a defect in which the fetal shunt between the aorta & the pulmonary artery fails to close
c. is a stenotic lesion that is surgically corrected at birth
d. causes an abnormal opening between the 4 chambers of the heart

A

B. Involves a defect in which the fetal shunt between the aorta & pulmonary artery fails to close

26
Q

What is patent ductus arteriosus?

A

Failure of the fetal shunt between the aorta & pulmonary artery to close

27
Q

What happens with a patent ductus arteriosus?

A

allows blood to flow from the high pressure aorta to the low pressure pulmonary artery

Causes a left to right shunt!!

28
Q

True or false patent ductus arteriosus is not a stenotic lesion

A

True

29
Q

Can patent ductus arteriousus be closed?

A

yes both surgically & medically

30
Q

What happens with a atrioventricular defect?

A

fetal development of the endocardial cushions is disturbed

Causes problems in the atrial & ventricular septa & artoventricular valves

31
Q

Why might a newborn infant with a cardiac defect such as coarctation of the aorta causing a right to left shunt receive prostaglandin E?

a. decrease inflammation
b. to control pain
c. to decrease resp
d. to keep the ductus arteriosus patent

A

D. to keep the ductus arteriosus patent

Prostaglandin E is given to infants with a right to left shunt to keep the ductus arteriosus patent to increase pulmonary blood flow

The prostaglandin keeps the door open to help with blood flow!!

32
Q

Which ventricular septal defect results in increased pulmonary blood flow?

a. ventricular septal defect
b. coarctation of the aorta
c. tetralogy of fallot
d. pulmonary stenosis

A

a. ventricular septal defect

Causes left to right shunting of blood. This increases pulmonary blood flow.

33
Q

Coarctation of the aorta is a stenotic lesion

A

that causes increased resistance to blood flow from the proximal distal aorta

34
Q

The defects of Tetralogy of Fallot cause right to left shunting

A

decreases pulmonary blood flow

35
Q

Pulmonary stenosis causes obstruction of blood flow from the

A

right ventricle to the pulmonary artery

Pulmonary blood flow is decreased

36
Q

What nursing action is appropriate to take when an infant with conenital heart defect has an increased RR, sweating, poor feeding?

A

alert MD- signs of CHF

Dig & furosemide can help improve heart function & decrease fluid retention

37
Q

CHF baby

A

give rest periods

Pediatric (20 decks)

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