Arrhythmia in Children

Correct Answer: A

Rationale: In pediatric nursing, understanding arrhythmias in children is crucial for providing safe and effective care. In this context, the correct answer is A) Re-entry Tachycardia is the commonest. Re-entry tachycardia, specifically AV nodal re-entry tachycardia (AVNRT), is one of the most common types of supraventricular tachycardia (SVT) in children. It occurs due to a re-entrant circuit within the AV node, leading to rapid heart rates. Option B) Adenosine decreases the force of cardiac contractility is incorrect. Adenosine is a first-line medication for terminating SVT by blocking AV nodal conduction, not by affecting cardiac contractility. Option C) SVT can cause hydrops foetalis is incorrect. Hydrops foetalis is a condition of severe fetal edema, usually caused by conditions such as immune hydrops or fetal heart failure, not SVT. Option D) Valsalva maneuver can restore sinus rhythm is incorrect. While the Valsalva maneuver can be used to help diagnose and sometimes treat certain arrhythmias, it is not typically effective in restoring sinus rhythm in pediatric patients with arrhythmias. Understanding pediatric arrhythmias, their common presentations, diagnostic tools, and treatment modalities is essential for pediatric nurses. Being able to differentiate between various types of arrhythmias and their management strategies ensures timely and appropriate interventions to promote positive patient outcomes.

Correct Answer: B

Rationale: In the context of pediatric nursing and pharmacology, understanding congenital complete heart block is crucial. The correct answer, option B - SLE mother's child, is the most appropriate choice because congenital complete heart block can be associated with maternal systemic lupus erythematosus (SLE). This autoimmune condition can lead to the development of autoantibodies that cross the placenta and affect the fetal heart's electrical conduction system, resulting in complete heart block. Option A - Corrected TGA (transposition of the great arteries) is incorrect as it does not directly relate to congenital complete heart block. Option C - Prolonged QT syndrome is also incorrect as it pertains to a different cardiac condition characterized by a prolonged QT interval on an electrocardiogram. Option D - MgSO4 therapy to the mother is unrelated to congenital complete heart block and is typically used for conditions like preeclampsia. Educationally, this question highlights the importance of recognizing the potential maternal factors that can contribute to congenital heart block in infants. It underscores the need for nurses to assess and monitor infants born to mothers with autoimmune conditions like SLE to provide appropriate care and interventions. Understanding these connections is essential for pediatric nurses caring for infants with congenital heart conditions.

Correct Answer: C

Rationale: In pediatric nursing, understanding cardiovascular conditions like coarctation of the aorta is essential for providing safe and effective care to young patients. In this case, the correct answer is option C: "Radio femoral delay is a feature." This is because coarctation of the aorta often presents with a characteristic finding of delayed or diminished pulse in the femoral artery compared to the radial artery. Option A, "Associated with Turner's syndrome," is incorrect because although Turner's syndrome is associated with various cardiovascular anomalies, it is not directly linked to coarctation of the aorta. Option B, "Commonest is preductal type," is incorrect as coarctation of the aorta is more commonly seen in the postductal type. Option D, "Systolic BP in lower limb is higher than in upper limb," is incorrect because in coarctation of the aorta, there is typically higher blood pressure in the upper extremities compared to the lower extremities due to the obstruction in the aorta. Educationally, understanding the characteristic clinical manifestations of coarctation of the aorta, such as radio femoral delay, helps nurses and healthcare providers in early recognition, timely intervention, and appropriate management of this condition in pediatric patients. Recognition of these key features can lead to better outcomes and improved quality of care for children with congenital heart defects.

Correct Answer: C

Rationale: In the context of pediatric nursing and cardiovascular pharmacology, the correct initial treatment choice for a symptomatic patient with isolated pulmonic stenosis is balloon catheter valvuloplasty (Option C). This intervention involves using a balloon catheter to dilate the stenotic pulmonary valve, improving blood flow through the pulmonary artery. Option A, closed surgical blade valvotomy, and Option B, open surgical valvotomy, involve surgical procedures that are more invasive and carry higher risks compared to the less invasive balloon catheter valvuloplasty. In pediatric patients, less invasive approaches are preferred whenever possible to minimize risks and promote faster recovery. Option D, Blalock-Taussig shunt, is not the initial treatment of choice for isolated pulmonic stenosis. A Blalock-Taussig shunt is typically used in patients with cyanotic congenital heart defects to increase pulmonary blood flow. Understanding the appropriate initial treatment for pediatric patients with cardiovascular conditions like pulmonic stenosis is crucial for nurses caring for these patients. Balloon catheter valvuloplasty is a safe and effective intervention that can significantly improve the symptoms and outcomes of children with isolated pulmonic stenosis, making it the preferred choice in this scenario.

Correct Answer: D

Rationale: The correct answer is D) patent ductus arteriosus (PDA). In this case, the symptoms of tachycardia, tachypnea, poor feeding, continuous machinery murmur, wide pulse pressure, and prominent apical impulse are indicative of PDA. A PDA is a congenital heart defect where the ductus arteriosus, a normal fetal blood vessel that connects the pulmonary artery to the aorta, fails to close after birth. This leads to abnormal blood flow between the aorta and pulmonary artery, causing the symptoms seen in the infant. Now, let's examine why the other options are incorrect: A) Pulmonic stenosis: Typically presents with a systolic ejection murmur and right ventricular heave, not the symptoms described. B) Aortic stenosis: Symptoms would include a systolic ejection murmur and possibly a thrill, not continuous machinery murmur. C) Ventricular septal defect: Would present with a harsh holosystolic murmur, not a continuous machinery murmur and wide pulse pressure. Understanding pediatric cardiovascular conditions is crucial for nurses caring for infants with congenital heart defects. Recognizing the specific signs and symptoms of each condition is vital for timely intervention and appropriate management to improve outcomes for pediatric patients.