A 16-year-old being treated for hypertension has laboratory values of: Hemoglobin: 16 g/dL Hematocrit: 43% Sodium: 139 mEq/L Potassium: 4.4 mEq/L Total cholesterol: 220 mg/dL Which drug does the nurse suspect the patient takes based on the total cholesterol?

Correct Answer: A

Rationale: The correct answer is A) Beta blockers. Beta blockers are often prescribed for patients with hypertension due to their ability to reduce heart rate and blood pressure by blocking the action of adrenaline. Elevated cholesterol levels are a common side effect of beta blockers, which can lead to an increase in total cholesterol levels as seen in this patient. This indicates that the patient is likely taking beta blockers. Option B) Calcium channel blockers work by relaxing blood vessels and reducing the heart's workload, but they are not typically associated with elevated cholesterol levels. Option C) ACE inhibitors work by dilating blood vessels to lower blood pressure and improve blood flow. They do not typically affect cholesterol levels. Option D) Diuretics help the body get rid of excess sodium and water to lower blood pressure. They are not known to cause elevated cholesterol levels. Understanding the relationship between medication classes and their potential side effects is crucial in pharmacology, especially in pediatric cardiovascular nursing. By recognizing the side effects of specific drugs, nurses can anticipate potential complications and provide appropriate patient education and monitoring.

Correct Answer: B

Rationale: In the context of pediatric cardiovascular nursing, the correct answer to the question regarding the use of aspirin in a child with rheumatic fever (RF) is option B: Reduce joint inflammation. Aspirin is prescribed for children with RF to help alleviate joint pain and inflammation, which are common symptoms of this condition. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that can help reduce inflammation in the joints affected by RF, thus improving the child's comfort and mobility. Option A: Keeping the patent ductus arteriosus (PDA) open is not a correct rationale for prescribing aspirin in a child with RF. PDA closure is not a primary indication for aspirin therapy in this context. Option C: Decreasing swelling of strawberry tongue is also not a primary reason for using aspirin in RF. Strawberry tongue is a clinical sign of RF but is not directly treated with aspirin. Option D: Treating ventricular hypertrophy of endocarditis is not a correct rationale for administering aspirin in a child with RF. Ventricular hypertrophy is a cardiac complication that may occur in RF, but it is not a direct indication for aspirin therapy. Educationally, understanding the rationale behind prescribing medications in pediatric cardiovascular conditions like RF is crucial for nurses caring for these patients. By knowing the specific indications for medications like aspirin, nurses can provide safe and effective care to children with RF and help manage their symptoms appropriately.

Correct Answer: C

Rationale: The correct answer is C) "I know she will be irritable for 2 months after her symptoms start." In Kawasaki disease (KD), a vasculitis affecting children, irritability is a common symptom during the subacute phase which occurs after the acute phase. This phase can last for several weeks to a couple of months, and it is important for parents to be aware of this to provide appropriate support and care for their child during this time. Option A is incorrect because arthritis is not a typical manifestation of KD, and knee replacements are not a standard treatment for this condition. Option B is incorrect as diphenhydramine is not used for peeling palms and soles in KD. Option D is incorrect as high doses of Tylenol are not the primary treatment for inflammation in KD. Educationally, this question reinforces the importance of patient education in pediatric cardiovascular nursing. It highlights the need for parents to understand the different phases and symptoms of KD to effectively care for their child at home. By knowing what to expect, parents can better support their child's recovery and communicate effectively with healthcare providers.

Correct Answer: B

Rationale: The Norwood procedure is a surgical intervention used to correct hypoplastic left heart syndrome (HLHS), making option B the correct answer. HLHS is a congenital heart defect where the left side of the heart is underdeveloped, resulting in inadequate circulation. The Norwood procedure involves restructuring the heart to improve blood flow and function. Option A, transposition of the great vessels, is corrected through procedures like the arterial switch operation, not the Norwood procedure. Option C, Tetralogy of Fallot, is typically managed with surgical repair of the heart defects involved, not the Norwood procedure. Option D, patent ductus arteriosus, is often treated with medications or minimally invasive procedures, not the Norwood procedure. Understanding which cardiac conditions require specific interventions is crucial in pediatric cardiovascular nursing. This knowledge ensures appropriate care is provided to children with complex congenital heart defects. Educators should emphasize the importance of precise diagnosis and treatment planning to optimize outcomes in pediatric cardiology practice.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Coarctation of the aorta (COA). COA is a congenital heart defect characterized by a narrowing of the aorta, leading to increased blood pressure proximal to the defect and decreased pressure distally. The symptoms of dizziness, headache, fainting, and epistaxis (nosebleed) are indicative of the increased pressure in the upper body and head due to the narrowing of the aorta. The bounding radial pulses are a sign of increased pressure in the upper extremities. Option A) Transposition of the great vessels is incorrect because it typically presents with cyanosis in newborns due to a mixing of oxygenated and deoxygenated blood. Option C) Aortic stenosis is unlikely as it would present with a systolic ejection murmur and possibly chest pain, not the symptoms described in the scenario. Option D) Pulmonic stenosis is also not the correct answer as it would manifest with a systolic ejection murmur and possibly cyanosis, not the symptoms presented. Educationally, understanding the different congenital heart defects and their clinical presentations is crucial for pediatric nurses to provide timely and appropriate care. Recognizing the specific signs and symptoms of COA can lead to prompt intervention and prevent further complications in pediatric patients with this condition.