Depending on the frequency and severity of hypercyanotic attacks in tetralogy of Fallot, all the following procedures are true EXCEPT

Correct Answer: D

Rationale: In the management of hypercyanotic attacks in tetralogy of Fallot, it is crucial to understand the appropriate interventions to ensure positive outcomes. In this scenario, the correct answer is D) rapid correction with intravenous sodium bicarbonate. This option is incorrect because giving sodium bicarbonate can worsen acidosis, leading to further compromise in patients with tetralogy of Fallot experiencing hypercyanotic attacks. A) Placement of the infant in the knee-chest position is a correct intervention as it helps improve systemic vascular resistance, decrease the right-to-left shunt, and enhance pulmonary blood flow, thereby reducing cyanosis. B) Administration of oxygen is also a correct intervention as it helps increase oxygen saturation levels in the blood, alleviating cyanosis and improving tissue oxygenation. C) Injection of morphine subcutaneously is a correct intervention as it can help reduce systemic vascular resistance, decrease anxiety and distress in the patient, and improve oxygen delivery to tissues. Educationally, understanding the rationale behind each intervention is crucial for nurses caring for pediatric patients with cardiovascular disorders. This knowledge equips them with the skills needed to provide prompt and effective care during acute episodes, ensuring better patient outcomes. It also highlights the importance of individualized care and the significance of evidence-based practice in pediatric pharmacology.

Correct Answer: A

Rationale: In pediatric patients, the most common cause of pulmonary hypertension is idiopathic pulmonary hypertension (Option A). This is because idiopathic pulmonary hypertension refers to high blood pressure in the lungs with no known underlying cause, which can often be seen in children. Option B, pulmonary venoocclusive disease, is a rare condition characterized by blockages in the small veins in the lungs, more commonly seen in adults. Left-sided valvular heart disease (Option C) typically leads to pulmonary congestion rather than pulmonary hypertension in pediatric patients. Chronic obstructive pulmonary disease (Option D) is primarily a disease of adults and is not a common cause of pulmonary hypertension in children. In an educational context, understanding the etiology of pulmonary hypertension in pediatric patients is crucial for nurses caring for these children. It aids in early recognition of symptoms, appropriate interventions, and better patient outcomes. By knowing the common causes, healthcare providers can tailor their treatment plans effectively and provide optimal care for pediatric patients with cardiovascular disorders.

Correct Answer: B

Rationale: In urgent situations of supraventricular tachycardia (SVT) with severe heart failure symptoms, the initial management is DC cardioversion. This is the correct choice because in cases where SVT leads to severe heart failure symptoms like hypotension, altered mental status, or signs of shock, immediate restoration of normal sinus rhythm is crucial to stabilize the patient's condition. DC cardioversion provides a synchronized shock to the heart, effectively terminating the arrhythmia and restoring normal rhythm promptly. Option A, adenosine by rapid intravenous push, is commonly used for stable SVT to help identify the underlying rhythm but is not ideal in cases of severe heart failure due to its potential to transiently worsen the arrhythmia or cause hypotension. Option C, verapamil, is contraindicated in patients with severe heart failure due to its negative inotropic effects, which can further compromise cardiac function. Option D, digoxin, is also not recommended in acute situations of severe heart failure associated with SVT, as its onset of action is slower compared to DC cardioversion, which is needed for immediate stabilization. Educationally, understanding the rationale behind the choice of DC cardioversion in this scenario reinforces the importance of rapid intervention in critical pediatric cardiovascular emergencies. It highlights the need for healthcare providers to be prepared to perform urgent procedures like cardioversion to address life-threatening conditions effectively. This knowledge is essential for nurses caring for pediatric patients with cardiac disorders to ensure timely and appropriate interventions in emergency situations.

Correct Answer: D

Rationale: In pediatric cardiovascular disorders nursing, understanding restrictive cardiomyopathy (RCM) is crucial. The correct answer, D) normal atrial chamber dimensions, is indicative of RCM. RCM is characterized by stiff ventricular walls leading to impaired diastolic filling, resulting in normal ventricular chamber dimensions but with increased atrial pressures causing atrial dilation. Option A) normal ventricular chamber dimensions is incorrect as RCM typically presents with normal ventricular chamber size. Option B) normal myocardial wall thickness is also incorrect as RCM can present with increased myocardial wall thickness due to fibrosis. Option C) preserved systolic function is incorrect as RCM usually results in diastolic dysfunction while systolic function may be impaired in some cases. Educationally, this question highlights the importance of recognizing key features of RCM in pediatric patients. Understanding these distinctions is vital for accurate diagnosis, appropriate management, and improving patient outcomes in pediatric cardiology. Nurses need to be well-versed in the nuances of pediatric cardiovascular disorders to provide optimal care and support to their young patients and their families.

Correct Answer: B

Rationale: In the context of pediatric cardiovascular disorders nursing, understanding the adverse reactions associated with angiotensin-converting enzyme inhibitors (ACEIs) is crucial for safe and effective patient care. The correct answer, option B) hypokalemia, is not typically an adverse reaction to ACEIs. Explanation: A) Hypotension is a common adverse reaction to ACEIs due to their mechanism of action in dilating blood vessels, leading to decreased blood pressure. C) Maculopapular rash can occur as a hypersensitivity reaction to ACEIs, indicating an immune response. D) Renal toxicity is a serious potential adverse effect of ACEIs, as these medications can affect renal function and electrolyte balance. Educational context: Educators should emphasize the importance of monitoring for adverse reactions when administering ACEIs to pediatric patients with cardiovascular disorders. Understanding the expected adverse effects and recognizing when to intervene is critical in ensuring patient safety. By knowing the potential side effects of ACEIs, nurses can provide proactive care and prevent complications in pediatric patients receiving these medications.