Congenital complete heart block

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 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.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) severe aortic stenosis. Aortic stenosis is a congenital heart defect characterized by narrowing of the aortic valve, leading to reduced blood flow from the left ventricle to the aorta. In pediatric patients, severe aortic stenosis can present with symptoms such as chest pain, fatigue, and in severe cases, heart failure. Option B) patent ductus arteriosus is incorrect because it is a separate congenital heart defect involving the persistence of a normal fetal connection between the aorta and the pulmonary artery, which can lead to abnormal blood flow in the heart. Option C) Williams syndrome is a genetic disorder that can present with cardiovascular abnormalities, but it is not specifically associated with aortic stenosis. Understanding these distinctions is crucial for pediatric nurses as they care for children with cardiovascular conditions. Recognizing the signs and symptoms of aortic stenosis, as well as other cardiac defects, is essential for timely intervention and management to prevent complications and improve patient outcomes.

Correct Answer: B

Rationale: In this scenario, the most likely diagnosis is supraventricular tachycardia (SVT) (Option B). SVT is a common arrhythmia in infants, characterized by sudden onset tachycardia, which can present with symptoms like dyspnea, tachypnea, and a gallop rhythm. The absence of a heart murmur suggests a non-structural cause, further supporting SVT as the diagnosis. Option A, sepsis, is less likely due to the absence of other systemic signs like hypotension and poor perfusion. Ingestion (Option C) would typically present with other symptoms and signs related to the specific ingested substance. Ventricular tachycardia (Option D) is less common in infants without underlying structural heart disease. Educationally, understanding cardiac arrhythmias in pediatric patients is crucial for nurses. Recognizing the signs and symptoms of SVT in infants, along with appropriate interventions like vagal maneuvers or adenosine administration, is essential for providing safe and effective care. This case highlights the importance of quick and accurate assessment in pediatric cardiovascular emergencies.