One of the following is a sign of right-sided heart failure of the patient

Correct Answer: B

Rationale: In pediatric cardiovascular disorders, understanding the signs of right-sided heart failure is crucial for accurate assessment and timely intervention. The correct answer is B) orthopnea. Orthopnea is a classic sign of right-sided heart failure in patients, especially in pediatric cases. Orthopnea refers to difficulty breathing while lying flat and is relieved by sitting up or standing. This occurs because in right-sided heart failure, there is an increase in systemic venous pressure, leading to fluid accumulation in the lower extremities. When the child lies down, this fluid redistributes centrally, causing increased pressure on the lungs and making breathing difficult. A) Tachypnea is a common sign in heart failure but is not specific to right-sided heart failure. It can be present in both left and right-sided heart failure. C) Wheezing is more commonly associated with respiratory conditions such as asthma or bronchiolitis and is not a typical sign of right-sided heart failure. D) Pulmonary edema is a severe manifestation of left-sided heart failure where fluid accumulates in the lungs. It is not a direct sign of right-sided heart failure. Educationally, understanding the unique signs and symptoms of different types of heart failure in pediatric patients is essential for nurses to provide accurate assessments, early interventions, and effective care. Recognizing orthopnea as a sign of right-sided heart failure can help healthcare providers initiate appropriate treatments promptly and prevent complications in pediatric patients with cardiovascular disorders.

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.

Correct Answer: D

Rationale: In pediatric pharmacology, understanding pediatric cardiovascular disorders is crucial for nursing professionals. The correct answer to the question is option D, tricuspid atresia. Tricuspid atresia is a cyanotic cardiac lesion with decreased pulmonary blood flow because the tricuspid valve is completely absent in this condition. This results in deoxygenated blood bypassing the right ventricle and flowing directly into the pulmonary circulation, causing decreased pulmonary blood flow. Option A, transposition of the great vessels, involves a mixing of oxygenated and deoxygenated blood due to the aorta arising from the right ventricle and the pulmonary artery arising from the left ventricle, leading to increased pulmonary blood flow. Option B, single ventricle, and option C, truncus arteriosus, both present with increased pulmonary blood flow due to abnormal connections and shunting of blood in the heart. Understanding these distinctions is vital for nurses caring for pediatric patients with cardiovascular disorders as it impacts treatment strategies, monitoring, and overall patient outcomes. By comprehensively grasping the pathophysiology of these conditions, nurses can provide effective and individualized care to pediatric patients with cyanotic cardiac lesions.