A 10-year-old has undergone a cardiac catheterization. At the end of the procedure, the nurse should first assess:

Correct Answer: B

Rationale: In a pediatric patient who has undergone cardiac catheterization, the nurse's first assessment priority should be pulses (Option B). This is crucial because assessing pulses helps in evaluating the adequacy of circulation and detecting any potential complications such as vascular compromise or thrombosis post-procedure. Assessing pain (Option A) is important, but in this scenario, ensuring adequate perfusion takes precedence over pain assessment. Hemoglobin and hematocrit levels (Option C) are essential to monitor for potential bleeding complications, but this assessment would come after ensuring adequate perfusion by assessing pulses. Reviewing the catheterization report (Option D) is important for overall understanding of the procedure, but immediate post-procedure assessment of pulses is more critical for detecting any immediate issues. In an educational context, understanding the rationale behind prioritizing assessments in pediatric patients post-cardiac catheterization is vital for nurses caring for these patients. By recognizing the significance of assessing pulses first, nurses can provide prompt and appropriate interventions to ensure patient safety and optimal outcomes. This prioritization is based on the principles of pediatric cardiovascular nursing and critical thinking in assessing and managing post-procedural complications effectively.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Latex. The rationale for this lies in the fact that children with myelomeningocele, a neural tube defect, are at increased risk for latex allergy. Latex is commonly found in medical equipment, including catheters, and exposure can lead to allergic reactions ranging from mild irritation to severe anaphylaxis. Option A) Soy, Option C) Penicillin, and Option D) Dairy are incorrect choices in this context. While allergies to these substances are possible in pediatric patients, they are not specifically associated with myelomeningocele or cardiac catheterization procedures. Educationally, it is crucial for nurses caring for pediatric patients with myelomeningocele to be aware of the increased risk of latex allergy and take appropriate precautions to prevent exposure. This knowledge ensures the safety and well-being of the child during invasive procedures like cardiac catheterization. Additionally, understanding the specific risks and considerations for this patient population enhances the nurse's ability to provide high-quality, individualized care.

Correct Answer: A

Rationale: In the case of a child receiving aspirin therapy for Kawasaki disease (KD), exposure to chickenpox or influenza should be a cause to discontinue therapy and substitute dipyridamole (Persantine). This is because aspirin therapy in the presence of a viral infection like chickenpox or influenza can increase the risk of Reye's syndrome, a rare but serious condition that affects the liver and brain. Option A is correct because both chickenpox and influenza are viral infections that can increase the risk of Reye's syndrome when aspirin is used concurrently. Option B (E. coli or staphylococcus) and Option D (Streptococcus A or staphylococcus) are incorrect as these bacterial infections do not pose the same risk in relation to aspirin therapy in KD. Option C (Mumps or streptococcus A) is also incorrect as mumps is a viral infection that, like chickenpox and influenza, can increase the risk of Reye's syndrome with aspirin therapy. Educationally, it is crucial for healthcare providers to be aware of the potential complications and interactions that can arise in pediatric pharmacotherapy, especially in conditions like KD where aspirin is a key component of treatment. Understanding the specific contraindications and risks associated with different infections and medications is essential for safe and effective patient care.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Lipid profile. The rationale behind this recommendation is to assess the child's risk factors for cardiovascular disorders due to family history. A lipid profile measures the levels of cholesterol and triglycerides in the blood, which are important indicators of cardiovascular health. Children with a family history of premature cardiovascular disease are at higher risk, and early detection through lipid profiling can help in implementing preventive measures such as lifestyle modifications and potential pharmacological interventions. Option A) Electrocardiogram (ECG) is not the most appropriate choice in this situation because it primarily provides information about the electrical activity of the heart. While an ECG can be useful in specific cardiac conditions, it is not the primary screening tool for assessing cardiovascular risk in a child with a family history of myocardial infarction. Option C) Echocardiogram is a diagnostic tool that uses sound waves to create images of the heart structure and function. While echocardiography is valuable in evaluating congenital heart defects or specific cardiac abnormalities, it is not typically indicated as an initial screening test in this context. Option D) Cardiac catheterization is an invasive procedure used to diagnose and treat certain heart conditions by inserting a catheter into the heart's blood vessels. It is an aggressive approach that is not warranted as a routine screening test for a toddler with a family history of myocardial infarction. In an educational context, understanding the rationale behind choosing the appropriate diagnostic tests based on clinical scenarios is crucial for nurses and healthcare professionals. It helps in developing critical thinking skills and evidence-based practice, ensuring that patient care is individualized and effective. By grasping the significance of early risk assessment and preventive strategies in pediatric cardiovascular health, nurses can contribute to promoting long-term well-being in children at risk.

Correct Answer: B

Rationale: The correct answer is B) Your baby's defect is small and will likely close on its own by 1 year of age. This response is the best because it reflects the current understanding of ventricular septal defects (VSDs) in pediatric patients. In infants, small VSDs often close spontaneously as the child grows, reducing the need for surgical intervention. This information is crucial for parents to understand to alleviate unnecessary anxiety and concern about their baby's condition. Option A) It is always helpful to get a second opinion about any serious condition like this. While seeking a second opinion is generally a good practice in medical decision-making, in this case, it may not address the specific nature of VSDs in infants and could potentially lead to unnecessary procedures or interventions. Option C) It is common for physicians to wait until an infant develops respiratory distress before they do the surgery. This statement is incorrect as waiting for the development of respiratory distress in an infant with a small VSD is not a recommended approach. Surgical intervention is typically not the first-line treatment for small VSDs in infants. Option D) With a small defect like this, they wait until the child is 10 years old to do the surgery. This option is incorrect as it provides misinformation about the appropriate timing for surgical intervention in cases of small VSDs in infants. Waiting until the child is 10 years old for surgery is not aligned with current medical guidelines for managing VSDs in pediatric patients. Educational Context: Educating parents about the natural course of VSDs in infants is essential for promoting informed decision-making and reducing unnecessary anxiety. Providing accurate information about the expected outcomes and management strategies for small VSDs helps parents feel empowered and involved in their child's care. It is crucial for nurses to have a solid understanding of pediatric cardiovascular disorders like VSDs to effectively communicate with parents and support them in navigating their child's healthcare journey.