All patients with clinical evidence of a PDA are at increased risk for endocarditis. As a result, patients with PDA should be considered for irreversible closure EXCEPT

Correct Answer: A

Rationale: In pediatric cardiovascular nursing, understanding the management of patent ductus arteriosus (PDA) is crucial. The correct answer, A) small, hemodynamically insignificant PDA, is right because small, hemodynamically insignificant PDAs pose minimal risk for endocarditis and usually do not require closure. These PDAs are often asymptomatic and spontaneously close over time without intervention. Option B) small, hemodynamically significant PDA, carries a risk for complications and may require closure to prevent long-term effects on the heart. Moderate PDA (Option C) and large PDA (Option D) are both significant and may lead to complications such as congestive heart failure, pulmonary hypertension, or infective endocarditis if left untreated. In an educational context, it's essential for pediatric cardiovascular nurses to differentiate between the different sizes and hemodynamic significance of PDAs to provide appropriate care. Understanding the indications for PDA closure helps in making informed clinical decisions to optimize patient outcomes and prevent complications. Regular monitoring and assessment are key in managing patients with PDAs to determine the need for intervention based on individual patient characteristics.

Correct Answer: D

Rationale: In pediatric cardiovascular nursing, understanding the different types of cardiomyopathies is crucial. Diastolic dysfunction and normal systolic function are key characteristics of restrictive cardiomyopathy (option D). In this condition, the heart muscle becomes stiff, leading to impaired relaxation during diastole while maintaining normal contractility during systole. Option A, dilated cardiomyopathy, is characterized by impaired systolic function and dilation of the heart chambers, not diastolic dysfunction. Option B, hypertrophic cardiomyopathy, presents with thickening of the heart muscle leading to impaired diastolic function and potentially abnormal systolic function. Option C, left ventricular noncompaction, is associated with prominent trabeculations in the left ventricle but typically does not present with diastolic dysfunction as a primary feature. Educationally, understanding these distinctions is vital for nurses caring for pediatric patients with cardiovascular conditions. Recognizing the specific features of each type of cardiomyopathy helps in accurate diagnosis, appropriate management, and improved outcomes for pediatric patients with these complex cardiac disorders.

Correct Answer: C

Rationale: In pediatric cardiovascular nursing, understanding hypertension in children is crucial for early detection and management. The correct definition of hypertension in children being "average systolic blood pressure (SBP) and/or diastolic BP that is ≥95th percentile for age, sex, and height on ≥3 occasions" (Option C) is based on current pediatric guidelines. This definition emphasizes the importance of considering the child's age, sex, and height in determining hypertension, as these factors influence blood pressure norms in children. Option A is incorrect because it does not include height, which is an essential factor in determining blood pressure percentiles in children. Option B is incorrect because it mentions "on ≥2 occasions," whereas multiple readings across three separate occasions are necessary to diagnose hypertension accurately in children. Option D is incorrect as it sets the threshold at the 90th percentile, which is below the standard definition for pediatric hypertension. Educationally, this question highlights the precision required in diagnosing hypertension in children and underscores the need for healthcare providers to follow established guidelines for accurate assessment. Understanding the nuances of blood pressure measurements in pediatric patients is vital for providing optimal care and preventing long-term cardiovascular complications.

Correct Answer: C

Rationale: In pediatric cardiovascular nursing, understanding ECG findings is crucial for accurate assessment and management of cardiac conditions. In this scenario, the correct answer is C) RBBB in Ebstein anomaly. Ebstein anomaly is a rare congenital heart defect characterized by malformation of the tricuspid valve, leading to displacement of the valve leaflets into the right ventricle. This displacement can result in right bundle branch block (RBBB) on ECG due to the altered conduction pathways in the right ventricle. Option A) Bifid P waves in large VSD (ventricular septal defect) is incorrect because VSD typically presents with a wide fixed split S2 on auscultation, not bifid P waves on ECG. Option B) Complete heart block in cyanotic attacks of Tetralogy of Fallot is incorrect as complete heart block is not a typical ECG finding in Tetralogy of Fallot. Cyanotic spells in Tetralogy of Fallot are usually associated with decreased pulmonary blood flow and increased right-to-left shunting. Option D) Right axis deviation in tricuspid atresia is incorrect because tricuspid atresia is characterized by cyanosis and a right-to-left shunt, but it typically presents with left axis deviation on ECG due to right ventricular hypertrophy and leftward shift of the heart. Understanding these ECG findings in pediatric cardiovascular conditions is essential for nurses and healthcare providers to provide safe and effective care to pediatric patients with cardiac anomalies.

Correct Answer: C

Rationale: In the context of pediatric cardiovascular nursing and the association between Down syndrome and ventricular septal defect (VSD), option C, "Pulmonary Hypertension is a late complication," is the correct answer. The rationale behind this is that children with Down syndrome are at an increased risk of congenital heart defects, with VSD being one of the most common. Over time, if a VSD is left untreated or not closed surgically, it can lead to increased blood flow to the lungs, causing pulmonary hypertension as a late complication. This occurs due to the increased workload on the right side of the heart, leading to elevated pressures in the pulmonary circulation. Option A, stating that the VSD doesn't close spontaneously as in children without Down syndrome, is incorrect. VSDs in children with or without Down syndrome may close spontaneously, but if they persist, they can lead to complications. Option B, mentioning that an inaudible murmur is a characteristic feature or that the murmur is not audible, is incorrect. Murmurs associated with VSDs are typically audible on auscultation due to the turbulent blood flow across the defect. Option D, suggesting that if there is no murmur, the condition need not be investigated, is also incorrect. The absence of a murmur does not rule out the presence of a VSD, as some defects may be small and not produce a murmur. In an educational context, understanding the relationship between Down syndrome and congenital heart defects like VSD is crucial for pediatric nurses to provide comprehensive care to these vulnerable patients. Recognizing the potential complications such as pulmonary hypertension allows for early intervention and management, highlighting the importance of regular cardiac assessments and monitoring in children with Down syndrome.