The following are common side effects of sildenafil EXCEPT

Correct Answer: B

Rationale: In pediatric nursing, understanding pharmacology is crucial for safe and effective patient care. In the context of this question on sildenafil, a medication commonly used for erectile dysfunction and pulmonary arterial hypertension, it is important to recognize the common side effects to monitor for adverse reactions in pediatric patients. The correct answer, B) elevated liver function tests, is not a common side effect of sildenafil. This is crucial to note as liver function should be monitored due to potential adverse effects on the liver, but elevated liver function tests are not typically associated with sildenafil use. A) Flushing is a common side effect of sildenafil due to its vasodilatory effect. C) Headache is also common, as sildenafil can cause headaches due to changes in blood flow. D) Myalgia, or muscle pain, can occur as a side effect of sildenafil due to its effects on blood flow and muscle relaxation. Educationally, this question highlights the importance of understanding common medication side effects in pediatric patients. Monitoring for and recognizing these side effects is essential for providing quality nursing care and ensuring patient safety when administering medications like sildenafil to children.

Correct Answer: C

Rationale: In addressing the question about coarctation of the aorta in pediatric nursing, the correct answer is option C: diagnostic catheterization is mandatory before surgery. This is because in coarctation of the aorta, diagnostic catheterization is not always mandatory before surgery. In many cases, the diagnosis can be confirmed through non-invasive methods such as echocardiography, CT scans, or MRI. Option A: Notching of ribs is noted, is a characteristic physical finding in coarctation of the aorta due to collateral circulation that develops to bypass the obstruction. Option B: Doppler is useful for demonstrating severe obstruction, is true as Doppler ultrasound can show the flow characteristics and severity of the aortic obstruction. Option D: CT and MRI are valuable noninvasive tools for evaluation when the echocardiogram is equivocal, is also true as these imaging modalities can provide detailed anatomical information when echocardiography results are inconclusive. In an educational context, understanding the diagnostic modalities and management approaches in pediatric cardiovascular conditions like coarctation of the aorta is crucial for nurses caring for pediatric patients with congenital heart defects. Knowing the appropriate diagnostic tests and treatment options can help nurses provide optimal care and support to these vulnerable patients and their families.

Correct Answer: A

Rationale: In Ebstein anomaly, the severity of symptoms and degree of cyanosis are influenced by the displacement of the tricuspid valve. This is because Ebstein anomaly is characterized by a downward displacement of the tricuspid valve leaflets into the right ventricle, leading to atrialization of a portion of the right ventricle. This displacement affects the valve's function, causing regurgitation and decreased forward flow of blood, resulting in cyanosis and symptoms related to decreased cardiac output. Option A is correct as it directly relates to the primary anatomical defect in Ebstein anomaly. The displacement of the tricuspid valve is a hallmark feature of this condition. Option B, cardiac dysrhythmias, while they can occur in Ebstein anomaly, are not the primary determinant of symptom severity and cyanosis in this condition. Option C, atrial right-to-left shunt, is not the primary factor influencing symptom severity and cyanosis in Ebstein anomaly. While shunting can occur, it is secondary to the tricuspid valve abnormality. Option D, pulmonary vascular resistance, is not the primary determinant of symptoms in Ebstein anomaly. Although changes in pulmonary vascular resistance can impact clinical presentation, it is not the main driver in this congenital heart defect. Understanding the specific pathophysiology of Ebstein anomaly is crucial for nurses caring for pediatric patients with this condition. By grasping how the displacement of the tricuspid valve impacts cardiac function, nurses can better anticipate and manage symptoms and complications associated with Ebstein anomaly.

Correct Answer: C

Rationale: In the context of pediatric nursing and pharmacology, understanding the clinical manifestations of hypoplastic left-heart syndrome (HLHS) is crucial for early detection and intervention. In the first 48 hours of life, infants with HLHS often present with decreased systemic perfusion due to inadequate cardiac output. The correct answer, option C - bounding peripheral pulses, is indicative of the body's compensatory mechanism to maintain perfusion in the setting of a hypoplastic left heart. Bounding pulses reflect the heart's effort to push an adequate amount of blood to the body, compensating for the structural defect. Regarding why the other options are incorrect: A) "Always obvious color": This is incorrect because infants with HLHS may not always present with obvious color changes early on. Color changes can be subtle and may not be the most reliable indicator of cardiovascular compromise in this condition. B) "Deep-blue skin": While cyanosis can be a feature of HLHS, deep-blue skin specifically is not a typical presentation in the first 48 hours. Cyanosis may develop later as the condition progresses. D) "Occasional association with Turner syndrome": Turner syndrome is a separate genetic condition and is not directly related to the clinical manifestations of HLHS in the immediate postnatal period. Educational context: Understanding the clinical signs and symptoms of congenital heart defects like HLHS is essential for nurses caring for pediatric patients. Early recognition of subtle cues, such as bounding pulses, can prompt timely interventions and improve outcomes for these fragile infants. Pharmacological knowledge plays a role in managing these patients, especially in administering medications to support cardiac function and perfusion. Nurses must be adept at recognizing abnormal findings and understanding the underlying pathophysiology to provide safe and effective care for pediatric patients with complex cardiovascular conditions.

Correct Answer: B

Rationale: Phenytoin is an anti-epileptic drug commonly used to treat seizures. In the context of this question, it is also used for the treatment of digitalis intoxication. Digitalis, a medication used to treat heart conditions like heart failure and certain arrhythmias, can lead to toxicity if levels in the body become too high. Phenytoin helps counteract the effects of digitalis toxicity by stabilizing the electrical activity of the heart. Option A, supraventricular tachycardia, is incorrect because phenytoin is not typically used to treat this condition. Medications like adenosine or beta-blockers are more commonly used for supraventricular tachycardia. Option C, atrial fibrillation, is also incorrect as phenytoin is not a first-line treatment for this condition. Medications like beta-blockers, calcium channel blockers, or anti-coagulants are usually preferred for atrial fibrillation. Option D, ventricular tachycardia, is incorrect as well. Ventricular tachycardia is a serious arrhythmia that often requires immediate intervention with medications like amiodarone or electrical cardioversion. Understanding the specific indications for medications like phenytoin is crucial for nurses caring for pediatric patients, especially in the context of cardiovascular conditions and potential drug toxicities. It is essential for nursing students to grasp the rationale behind drug choices to provide safe and effective care to their patients.