ECG

Correct Answer: C

Rationale: In pediatric cardiovascular nursing, understanding ECG findings is crucial for accurate assessment and management of cardiac conditions. In this scenario, the correct answer is C) RBBB in Ebstein anomaly. Ebstein anomaly is a rare congenital heart defect characterized by malformation of the tricuspid valve, leading to displacement of the valve leaflets into the right ventricle. This displacement can result in right bundle branch block (RBBB) on ECG due to the altered conduction pathways in the right ventricle. Option A) Bifid P waves in large VSD (ventricular septal defect) is incorrect because VSD typically presents with a wide fixed split S2 on auscultation, not bifid P waves on ECG. Option B) Complete heart block in cyanotic attacks of Tetralogy of Fallot is incorrect as complete heart block is not a typical ECG finding in Tetralogy of Fallot. Cyanotic spells in Tetralogy of Fallot are usually associated with decreased pulmonary blood flow and increased right-to-left shunting. Option D) Right axis deviation in tricuspid atresia is incorrect because tricuspid atresia is characterized by cyanosis and a right-to-left shunt, but it typically presents with left axis deviation on ECG due to right ventricular hypertrophy and leftward shift of the heart. Understanding these ECG findings in pediatric cardiovascular conditions is essential for nurses and healthcare providers to provide safe and effective care to pediatric patients with cardiac anomalies.

Correct Answer: C

Rationale: In pediatric cardiovascular nursing, understanding the implications of different cardiac conditions on exercise tolerance is crucial. In this scenario, the correct answer is C) Aortic stenosis. Aortic stenosis is a congenital heart defect characterized by narrowing of the aortic valve, leading to decreased cardiac output. During vigorous exercise, the heart has to work harder to meet the increased demand for oxygen, which can exacerbate the effects of aortic stenosis and potentially lead to cardiac complications like arrhythmias or syncope. Option A) Prolonged QT interval is a risk factor for arrhythmias but does not directly contraindicate vigorous exercise. Option B) Maladie de Roger deformity is a rare congenital heart condition and its impact on exercise tolerance is not well-documented, making it a less likely choice. Option D) Bicuspid aortic valve is a common congenital heart defect, but unless it is causing significant aortic stenosis, it does not necessarily require avoidance of vigorous exercise. Educationally, this question highlights the importance of understanding how different cardiac conditions can impact exercise tolerance in pediatric patients. It emphasizes the need for nurses to recognize when certain activities should be limited to ensure the safety and well-being of their patients with cardiovascular issues.

Correct Answer: A

Rationale: In pediatric cardiovascular nursing, understanding hypertrophic obstructive cardiomyopathy (HOCM) is crucial. The correct answer is A) Causes LV outflow tract obstruction. HOCM is characterized by abnormal thickening of the heart muscle, particularly the left ventricle, leading to obstruction of the outflow tract. This obstruction impairs the heart's ability to pump effectively, causing symptoms like chest pain, dyspnea, and syncope. Option B) Occurs after adenoviral infection is incorrect because HOCM is primarily a genetic disorder, not typically associated with viral infections like adenovirus. Option C) Commonly occurs in infancy is incorrect because HOCM usually presents in adolescence or adulthood, although it can rarely occur in infancy. Option D) Double apical impulse is incorrect as it is a characteristic finding in conditions like hypertrophic cardiomyopathy, not specifically in HOCM. Educationally, knowing the key features of HOCM is vital for pediatric nurses to recognize symptoms, provide appropriate care, and educate patients and families. Understanding the pathophysiology of HOCM, including LV outflow tract obstruction, helps in early identification and management of this potentially life-threatening condition.

Correct Answer: B

Rationale: In pediatric cardiovascular nursing, understanding ECG findings in infancy is crucial for accurate assessment and intervention. The correct answer is B) PR interval is < 0.16 s. In infants, a normal PR interval is shorter (<0.16 sec) compared to adults due to their faster heart rate. This is important to recognize as abnormalities in PR interval can indicate heart block or conduction disturbances. Option A) T wave inversion present is incorrect for infants as it is a normal finding in newborns and young children due to their developing hearts. It is not typically a cause for concern in this age group. Option C) P wave < 3mm tall is incorrect as infant ECGs can have smaller amplitude P waves due to the thinner atrial walls and smaller muscle mass in infants. This is a normal variant in this population. Option D) QRS representing ventricular depolarization is incorrect because while this statement is true, the QRS complex alone does not specifically address the ECG findings in infancy. Understanding the PR interval is more critical in this context. Educationally, grasping these nuances in pediatric ECG interpretation prepares nurses to provide optimal care for infants with cardiovascular issues. Recognizing normal variations in ECG findings in infancy versus abnormal findings is essential for early detection and intervention in pediatric cardiac conditions.

Correct Answer: C

Rationale: In this case, the most likely diagnosis is a Ventricular Septal Defect (VSD). VSD is a common congenital heart defect in infants and young children. The clinical presentation of poor feeding, diaphoresis during feeding, poor growth, tachypnea, tachycardia, and signs of heart failure like a palpable parasternal lift, systolic thrill, and abnormal heart sounds are indicative of VSD. The chest radiograph showing cardiomegaly further supports this diagnosis. Option A, cardiomyopathy, is less likely in this case as the symptoms and signs described are more suggestive of a structural defect like VSD rather than a primary myocardial disease. Myocarditis (Option B) typically presents with more systemic symptoms like fever, malaise, and viral prodrome in addition to cardiac symptoms. Coarctation of the aorta (Option D) would not typically present with the combination of symptoms and signs described, such as the holosystolic murmur and mid-diastolic rumble. Educationally, understanding the clinical manifestations and diagnostic approach to pediatric cardiovascular conditions is crucial for nurses caring for pediatric patients. Recognizing the specific signs and symptoms associated with different cardiac defects allows for timely intervention and appropriate management to improve patient outcomes. A thorough understanding of the pathophysiology of congenital heart defects, such as VSD, is essential for providing safe and effective care to pediatric patients with cardiovascular issues.