Congenital heart disease causing cyanosis without respiratory distress include EXCEPT

Correct Answer: B

Rationale: In pediatric cardiovascular disorders, it is crucial to understand the relationship between congenital heart diseases and their clinical presentations. In this question, the correct answer is B) aortic stenosis. Aortic stenosis typically presents with symptoms such as chest pain, syncope, and heart failure but not cyanosis without respiratory distress. A) Tricuspid atresia is a cyanotic heart defect where the tricuspid valve is not formed correctly, leading to cyanosis due to decreased pulmonary blood flow. C) Ebstein anomaly is a rare congenital heart defect where the tricuspid valve is abnormally positioned, causing cyanosis due to right-to-left shunting. D) Pulmonary atresia is a cyanotic heart defect where the pulmonary valve does not form properly, resulting in cyanosis due to decreased pulmonary blood flow. Educationally, understanding the pathophysiology and clinical manifestations of different congenital heart diseases is essential for nurses caring for pediatric patients. Recognizing the specific signs and symptoms associated with each condition helps in timely diagnosis and appropriate management, ultimately improving patient outcomes.

Correct Answer: D

Rationale: In pediatric pharmacology, understanding the differences between SVT and physiologic sinus tachycardia is crucial for effective management of cardiovascular disorders in children. The correct answer, option D, is "evident change in heart rate with activity." 1. **Explanation of why option D is correct**: In SVT, the heart rate remains elevated and does not significantly change with activity as it is a sustained abnormal rhythm. On the other hand, in physiologic sinus tachycardia, the heart rate increases in response to factors like exercise and stress, showing an evident change with activity. 2. **Explanation of why others are wrong**: - Option A: Sudden onset and termination can be seen in both SVT and physiologic sinus tachycardia, so this alone does not differentiate between the two. - Option B: While a persistent ventricular rate of >180 bpm is often seen in SVT, it can also occur in physiologic sinus tachycardia, especially during stress or illness. - Option C: Fixed RR interval on ECG is a characteristic of SVT, indicating a regular and rapid rhythm, which is not present in physiologic sinus tachycardia. 3. **Educational context**: Understanding these distinctions is essential for nurses caring for pediatric patients with cardiovascular disorders. Recognizing the differences between SVT and physiologic sinus tachycardia helps in making accurate assessments, implementing appropriate interventions, and providing safe and effective care to children with these conditions. In conclusion, option D is the correct answer as the presence of an evident change in heart rate with activity is a key differentiating factor between SVT and physiologic sinus tachycardia in children. This knowledge is vital for pediatric nurses to ensure timely and accurate management of cardiovascular disorders in pediatric patients.

Correct Answer: C

Rationale: In pediatric cardiovascular disorders, a ventricular septal defect (VSD) is a common condition that may require surgical closure in certain cases. The correct answer, option C, states that patients with pulmonary vascular disease are not indicated for surgical closure of a VSD. This is because in the presence of pulmonary vascular disease, closure of the VSD can lead to increased pulmonary vascular resistance, worsening the patient's condition. Option A, patients who cannot thrive, is a valid indication for surgical closure as poor growth and development can be a sign of significant hemodynamic burden due to the VSD. Option B, patients whose symptoms cannot be controlled between 6 and 24 months, indicates a timeframe where symptoms should be managed medically before considering surgery if symptoms persist. Option D, patients older than 2 years with a large VSD associated with a Qs ratio greater than 2:1, highlights a scenario where surgical closure may be necessary due to the size of the defect and the hemodynamic consequences. In an educational context, understanding the indications for surgical closure of a VSD is crucial for pediatric nurses caring for patients with congenital heart defects. It is important to recognize when surgery is necessary to improve outcomes and quality of life for these patients while also being aware of contraindications that could worsen their condition.

Correct Answer: A

Rationale: In neonates, sinus bradycardia is considered when the sinus rate is <100 beats/min. This is the correct answer because neonates have higher baseline heart rates compared to older children and adults. A heart rate <100 beats/min in a neonate may indicate inadequate cardiac output and requires further evaluation and management. Option B) <90 beats/min is incorrect because it may be within the normal range for older children and adults but is not appropriate for neonates. Option C) <80 beats/min and Option D) <70 beats/min are even lower and would indicate more severe bradycardia in neonates, requiring immediate intervention. It is crucial for pediatric nurses to understand the normal vital signs for different age groups, especially neonates who have unique physiological parameters. Recognizing abnormal heart rates in neonates is essential for early intervention to prevent complications. Nurses caring for pediatric patients must be knowledgeable about assessing and interpreting vital signs accurately to provide safe and effective care.

Correct Answer: C

Rationale: The correct answer is C) single positive blood culture. The Duke criteria are used to diagnose infective endocarditis. A single positive blood culture for a typical pathogen, such as Staphylococcus aureus, Streptococcus viridans, or Enterococcus, is considered a major criterion for the diagnosis. This is because blood cultures are crucial for identifying the causative organism responsible for infective endocarditis. Option A) new regurgitant flow by echocardiography is not a major criterion in the Duke criteria. While echocardiography is essential in diagnosing endocarditis, regurgitant flow alone is not specific enough to confirm the diagnosis. Option B) Osler nodes are a physical finding associated with endocarditis, but they are considered a minor criterion, not a major criterion in the Duke criteria. Option D) serologic evidence of infection is not a major criterion in the Duke criteria. While serological tests can be helpful in supporting a diagnosis of endocarditis, they are not considered a major criterion according to the Duke criteria. Understanding the Duke criteria is essential for nurses caring for pediatric patients with cardiovascular disorders. By knowing the specific criteria for diagnosing endocarditis, nurses can work closely with the healthcare team to ensure timely and accurate diagnosis and treatment of this serious condition.