The most common cardiac dysrhythmia in pediatrics is:

Correct Answer: C

Rationale: The correct answer is C) Supraventricular tachycardia. In pediatrics, supraventricular tachycardia (SVT) is the most common cardiac dysrhythmia. SVT is characterized by a rapid heart rate originating above the ventricles. This dysrhythmia can present with symptoms such as palpitations, chest pain, dizziness, and fatigue in pediatric patients. Option A) Ventricular tachycardia is less common in pediatric patients compared to SVT. Ventricular tachycardia is a serious arrhythmia that originates in the ventricles and can lead to hemodynamic instability. Option B) Sinus bradycardia refers to a slow heart rate originating from the sinus node. While it can occur in pediatrics, it is not as common as SVT. Option D) First-degree heart block is a conduction abnormality characterized by a delay in the electrical conduction between the atria and ventricles. It is not typically the most common dysrhythmia in pediatrics. Understanding the prevalence of different cardiac dysrhythmias in pediatric patients is crucial for nurses and healthcare providers involved in the care of children with cardiovascular conditions. Recognizing and managing SVT promptly is essential to prevent complications and ensure optimal outcomes for pediatric patients.

Correct Answer: B

Rationale: In pediatric patients, administering digoxin requires a thorough assessment to ensure safe and effective medication administration. The correct answer is option B, which is to assess the apical pulse rate. This is crucial because digoxin is a medication that affects the heart by increasing the strength and efficiency of its contractions. Monitoring the pulse rate helps to prevent potential toxicity, as bradycardia is a common sign of digoxin overdose in children. Option A, assessing the sclera, is not directly related to digoxin administration in pediatrics. While jaundice may indicate liver dysfunction, it is not a specific assessment for digoxin. Option C, assessing cough, is not a primary concern before administering digoxin. Cough could be indicative of respiratory issues or other conditions, but it is not a direct consideration for digoxin administration. Option D, liver function tests, are important for monitoring patients on long-term digoxin therapy due to the drug's hepatic metabolism. However, this is not typically assessed prior to a single dose administration of digoxin in a pediatric setting. Educationally, understanding the rationale behind assessing the apical pulse rate before administering digoxin highlights the importance of tailored assessments for pediatric patients to ensure medication safety and efficacy. Nurses must be diligent in their assessments to prevent adverse reactions and promote positive patient outcomes.

Correct Answer: B

Rationale: In the context of pediatric cardiovascular conditions, the correct answer to the question, "Which patient could require feeding by gavage?" is option B) Toddler with repair of transposition of the great vessels. Gavage feeding, also known as tube feeding, may be necessary in this case due to the postoperative recovery period following a major cardiac surgery like the repair of transposition of the great vessels. In this scenario, the correct answer is right because after undergoing such a complex surgical procedure, the toddler may have temporary difficulty with oral feeding due to factors like intubation, prolonged anesthesia, or decreased appetite. Gavage feeding ensures adequate nutrition and hydration during this critical recovery phase when oral intake may be insufficient. Now, let's explore why the other options are incorrect: - Option A) Infant with congestive heart failure (CHF): While infants with CHF may have feeding difficulties, gavage feeding is not typically the first-line intervention in managing CHF unless there are severe complications affecting oral intake. - Option C) Toddler with Kawasaki disease (KD) in the acute phase: Children with KD may have fever and inflammation, but gavage feeding is not typically a primary intervention for this condition unless there are specific complications impacting oral feeding. - Option D) School-age child with rheumatic fever (RF) and chorea: Chorea, a movement disorder associated with RF, does not directly indicate the need for gavage feeding. Nutritional support in RF is generally managed through standard oral intake unless there are specific complications. Educationally, understanding the rationale behind the need for gavage feeding in pediatric patients with complex cardiovascular conditions is crucial for nurses and healthcare providers. It highlights the importance of individualized care and appropriate nutrition support strategies in addressing the unique needs of children recovering from cardiac surgeries. This knowledge enhances patient safety, promotes optimal recovery outcomes, and underscores the significance of comprehensive care in pediatric pharmacology and nursing practice.

Correct Answer: C

Rationale: In the context of caring for a child with rheumatic fever (RF), option C, "I will give him the aspirin that is ordered for pain and inflammation," is the correct choice. This statement demonstrates a good understanding because aspirin is commonly prescribed to manage pain and inflammation in RF due to its anti-inflammatory and analgesic properties. Aspirin also helps prevent complications like rheumatic heart disease in RF patients. Option A suggesting applying heat to swollen joints is incorrect because heat can exacerbate inflammation and should be avoided in RF. Option B recommending gentle stretching exercises is also incorrect as aggressive exercise can lead to further joint damage in RF. Option D suggesting cold packs for reducing pain is not ideal as cold therapy can worsen vasoconstriction and pain in RF. Educationally, understanding the rationale behind the use of aspirin in RF is crucial for nursing students to provide safe and effective care to pediatric patients with this condition. It is essential for nurses to be aware of the appropriate pharmacological interventions and their implications in managing RF symptoms to promote optimal outcomes for these young patients.

Correct Answer: C

Rationale: In pediatric patients presenting with chest pain, pneumonia is the most common cause. This is due to the high prevalence of respiratory infections in children, leading to inflammation of the lung tissue and subsequent chest pain. Pneumonia can trigger pleuritic chest pain, which worsens with coughing or deep breathing. Myocarditis (option A) is less common in pediatric patients and is typically characterized by symptoms like fatigue, shortness of breath, and arrhythmias rather than isolated chest pain. Pericarditis (option B) is rare in children and is more commonly associated with viral infections or autoimmune conditions. Pleurisy (option D) refers to inflammation of the pleura, the lining around the lungs, and is less common than pneumonia in causing chest pain in pediatric patients. Educationally, understanding the differential diagnosis of chest pain in pediatric patients is crucial for nursing professionals. Recognizing pneumonia as a common cause can help in prompt evaluation, treatment, and alleviating parental anxiety. It also underscores the importance of thorough assessment and knowledge of age-specific conditions in pediatric pharmacology and nursing practice.