The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk exists of cerebrovascular accidents (strokes). Which is an important objective to decrease this risk?

Correct Answer: B

Rationale: In the context of caring for a child with persistent hypoxia due to a cardiac defect, preventing dehydration is crucial to decrease the risk of cerebrovascular accidents (strokes). Here's the detailed rationale: Preventing dehydration is essential because hypoxia places additional stress on the heart, potentially leading to decreased cardiac output and impaired circulation. Dehydration can further exacerbate these issues by reducing blood volume, which in turn increases the risk of clot formation and potential cerebrovascular accidents. Minimizing seizures (option A) is important in managing certain neurological conditions but is not directly related to reducing the risk of strokes in this scenario. Promoting cardiac output (option C) is a vital aspect of managing cardiovascular disorders, but dehydration directly impacts stroke risk and should be addressed first. Similarly, reducing energy expenditure (option D) may be important in conserving energy for a child with a cardiac defect, but it does not directly address the risk of strokes associated with dehydration. Educationally, understanding the interconnectedness of various physiological systems in pediatric patients with cardiac defects is crucial. Nurses must prioritize interventions based on the immediate risks to the child's health, such as preventing dehydration to reduce the risk of potentially life-threatening cerebrovascular accidents. This case highlights the importance of holistic care and the impact of fluid balance on cardiovascular health in pediatric patients.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the complications of rheumatic fever is crucial. The correct answer is D) Cardiac valve damage. Rheumatic fever is an inflammatory disease that can develop after a streptococcal infection, particularly in children. It primarily affects the heart, joints, skin, and brain. Cardiac valve damage is a common and serious complication of rheumatic fever, specifically involving the mitral valve. This damage can lead to valvular insufficiency or stenosis, impacting the heart's ability to effectively pump blood. Option A) Seizures are not a common complication of rheumatic fever. While neurological symptoms can occur in some cases, seizures are not a typical manifestation of this condition. Option B) Cardiac arrhythmias can occur as a result of rheumatic heart disease, but they are not the most common or serious complication associated with rheumatic fever. The primary concern lies in the structural damage to the heart valves. Option C) Pulmonary hypertension is not a direct complication of rheumatic fever. This condition typically arises from other underlying pulmonary or cardiac issues, rather than being a direct result of rheumatic fever. Educationally, it is important for pediatric nurses to recognize the signs and symptoms of rheumatic fever, understand its potential complications, and provide appropriate care and monitoring for affected children. By correctly identifying cardiac valve damage as a significant risk, nurses can intervene early to prevent further cardiac complications and improve patient outcomes.

Correct Answer: B

Rationale: The posttransplant course is complex. The leading cause of death after cardiac transplantation is rejection. Infection is a continued risk secondary to the immunosuppression necessary to prevent rejection. Cardiomyopathy is one of the indications for cardiac transplant. Heart failure is not a leading cause of death.

Correct Answer: B

Rationale: In septic shock, the correct answer is B) Increased cardiac output. Septic shock is characterized by a systemic inflammatory response to infection, leading to widespread vasodilation and decreased systemic vascular resistance. This causes blood to pool in the peripheral vessels, leading to decreased venous return and subsequent reduction in cardiac output. To compensate for this decrease, the body increases cardiac output by increasing heart rate and stroke volume. Option A) Hypothermia is incorrect because septic shock typically presents with fever or hyperthermia due to the body's response to infection. Option C) Vasoconstriction is incorrect because septic shock is characterized by vasodilation rather than vasoconstriction, leading to decreased systemic vascular resistance. Option D) Angioneurotic edema is incorrect because it is a condition characterized by localized swelling of the deeper layers of the skin and tissue, typically not a feature of septic shock. Educationally, understanding the pathophysiology of septic shock and its effects on the cardiovascular system is crucial for nurses caring for pediatric patients. Recognizing the signs and symptoms of septic shock, including the compensatory mechanism of increased cardiac output, is essential for prompt identification and intervention to improve patient outcomes.

Correct Answer: B

Rationale: In pediatric nursing, understanding the etiology of various cardiovascular disorders is crucial for effective patient care. In this context, the correct answer is B) Vitamin D dependent rickets type 2. This condition primarily results from a mutation in the gene encoding the Vitamin D receptor. Vitamin D dependent rickets type 1 (Option A) is caused by mutations in the CYP27B1 gene, leading to impaired activation of Vitamin D. X-linked hypophosphatemic rickets (Option C) is caused by mutations in the PHEX gene, affecting phosphate regulation. Autosomal dominant hypophosphatemic rickets (Option D) is caused by mutations in the FGF23 gene, disrupting phosphate metabolism. Educationally, understanding the genetic basis of various rickets types is essential for nurses caring for pediatric patients with cardiovascular disorders. This knowledge helps in accurate diagnosis, treatment planning, and patient education regarding the inheritance patterns and long-term management of these conditions. By grasping the genetic underpinnings, nurses can provide holistic care and support to pediatric patients and their families.