A nurse assesses a client 2 hours after a cardiac angiography via the left femoral artery. The nurse notes that the left pedal pulse is weak. Which action should the nurse take?

Correct Answer: C

Rationale: In this scenario, the correct action for the nurse to take is option C: Assess the color and temperature of the left leg. This is the most appropriate response because a weak left pedal pulse following cardiac angiography via the left femoral artery could indicate a potential complication such as impaired circulation, thrombosis, or arterial occlusion. By assessing the color and temperature of the left leg, the nurse can gather crucial information about tissue perfusion and potential vascular compromise. Option A, elevating the leg and applying a sandbag to the entrance site, is incorrect because in this situation, the priority is to assess for signs of decreased perfusion rather than passively elevating the leg. Increasing the flow rate of intravenous fluids (Option B) is not indicated without further assessment as it may not address the underlying cause of the weak pulse and could potentially exacerbate the issue. Documenting the finding as a +1/4 left pedal pulse (Option D) is insufficient as it does not address the need for immediate further assessment and intervention. Educationally, understanding the importance of prompt assessment and intervention in cases of altered perfusion post-cardiac procedures is vital for nurses caring for pediatric patients with cardiovascular disorders. Recognizing subtle changes in peripheral perfusion is crucial in preventing complications and ensuring optimal patient outcomes. Early detection and intervention can prevent more severe consequences such as limb ischemia or tissue damage.

Correct Answer: D

Rationale: In this scenario, the correct answer is option D, which is the 58-year-old male describing his pain as an intense stabbing that spreads across his chest. This client should be assessed first because the description of intense stabbing chest pain suggests a possible acute coronary syndrome (ACS), which requires immediate attention and intervention to prevent serious complications like myocardial infarction. Option A is less urgent because the dull ache with numbness in the fingers is less indicative of an acute cardiac event. Option B, moderate pain worse on inspiration, could suggest musculoskeletal or pulmonary causes rather than a cardiac origin. Option C, substernal pain radiating to the abdomen, may indicate a gastrointestinal issue or musculoskeletal problem rather than a primary cardiovascular concern. Educationally, this question highlights the importance of recognizing different types of chest pain presentations in the context of pediatric cardiovascular disorders. Nurses need to prioritize assessments based on the severity and characteristics of symptoms to provide timely and appropriate care, especially in emergency situations where quick decision-making is crucial for patient outcomes.

Correct Answer: D

Rationale: The child’s leg will have to be maintained in a straight position for approximately 4 hours. Younger children can be held in the parent’s lap with the leg maintained in the correct position. Postural drainage will not be performed unless the child has corresponding pulmonary problems. The child should be sedated to lie still, but being completely asleep is not necessary. The test will vary in length of time from start to finish.

Correct Answer: A

Rationale: Tetralogy of Fallot has these four characteristics: pulmonic stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. There is pulmonic stenosis but not atrial stenosis in tetralogy of Fallot. Right ventricular hypertrophy, not left ventricular hypertrophy, is present in tetralogy of Fallot. Tetralogy of Fallot has right ventricular hypertrophy, not left ventricular hypertrophy, and an atrial septal defect, not aortic hypertrophy.

Correct Answer: A

Rationale: In pediatric cardiovascular disorders, the use of angiotensin-converting enzyme (ACE) inhibitors like Captopril (Capoten) is crucial for managing conditions such as hypertension, heart failure, and certain congenital heart defects. The correct answer is A) Captopril (Capoten) because ACE inhibitors work by dilating blood vessels, reducing blood pressure, and improving cardiac function by inhibiting the conversion of angiotensin I to angiotensin II. Option B) Furosemide (Lasix) is a loop diuretic used to treat fluid overload by increasing urine output, but it does not have the same mechanism of action as ACE inhibitors in managing pediatric cardiovascular disorders. Option C) Spironolactone (Aldactone) is a potassium-sparing diuretic that works by blocking aldosterone receptors, mainly used for conditions like heart failure and edema, but not as the first-line treatment for pediatric cardiovascular disorders requiring ACE inhibitors. Option D) Chlorothiazide (Diuril) is a thiazide diuretic used to treat hypertension and edema by increasing urine output, but it does not have the same mechanism of action as ACE inhibitors in managing pediatric cardiovascular disorders. Educationally, understanding the rationale behind selecting the appropriate medication for pediatric cardiovascular disorders is crucial for nurses to ensure safe and effective pharmacological management. Knowledge of drug classes, mechanisms of action, and indications is essential for providing quality care to pediatric patients with cardiovascular conditions.