Aspirin has been ordered for the child with rheumatic fever (RF) in order to:

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: 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.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) ACE inhibitors. ACE inhibitors are contraindicated in pregnancy due to their potential to cause fetal harm, especially in the second and third trimesters. Since the sexually active adolescent female is using intermittent birth control, there is a risk of pregnancy if she were to become pregnant while on ACE inhibitors, it could harm the fetus. Beta blockers (option A) are generally considered safe for use in hypertension, but they may not be the best choice in this case due to their potential to mask certain symptoms of hypoglycemia, which could affect the efficacy of birth control. Calcium channel blockers (option B) are also commonly used in treating hypertension, but they do not carry the same risks as ACE inhibitors in pregnancy. Diuretics (option D) are another class of medications used in hypertension, but they do not pose the same risks in pregnancy as ACE inhibitors. Educationally, this question highlights the importance of considering the individual patient's circumstances when selecting medications, especially in vulnerable populations like adolescents. It underscores the need for healthcare providers to be aware of potential drug interactions and contraindications to ensure safe and effective treatment.

Correct Answer: C

Rationale: In managing congestive heart failure (CHF) in an infant, feeding in a semi-Fowler position (Option C) is the most appropriate plan. This position helps reduce the workload on the heart by decreasing venous return and preventing excessive fluid accumulation in the lungs. By positioning the infant upright, gravity assists in reducing the pooling of blood in the lungs and aids in easier breathing. Option A, promoting fluid restriction, may be necessary in some cases of CHF, but it is not the primary intervention for controlling CHF in infants. Option B, feeding a low-salt formula, may be beneficial in adult patients with heart failure, but infants require adequate salt for normal growth and development. Option D, encouraging breast milk, is generally beneficial for infants but does not directly address the management of CHF. In an educational context, understanding the physiology of CHF in infants is crucial for pediatric nurses. Teaching about proper positioning during feeding can significantly impact the management of CHF and improve outcomes for infants with this condition. Nurses need to be aware of the rationale behind each intervention to provide safe and effective care for pediatric patients with cardiovascular conditions.