ATI RN
Pediatric Cardiovascular Disorders Nursing Questions
Question 1 of 5
The primary care pediatric nurse practitioner is performing a well child examination on a school-age child who had complete repair of a tetralogy of Fallot (TOF) defect in infancy. What is important in this child's health maintenance regime?
Correct Answer: A
Rationale: In the case of a school-age child who had complete repair of a tetralogy of Fallot (TOF) defect in infancy, it is important for the primary care pediatric nurse practitioner to prioritize cardiology clearance for sports participation. This is the correct answer because children with TOF who have undergone complete repair can typically participate in physical activities and sports without significant restrictions. It is crucial to ensure the child's heart is functioning well and can handle the physical demands of sports to promote their overall health and well-being. Option B, restriction of physical activity to avoid pulmonary complications, is incorrect as children with TOF who have had complete repair do not typically require restrictions on physical activity unless there are specific concerns related to their individual health status. It is essential to encourage appropriate levels of physical activity for overall cardiovascular health. Option C, sub-acute bacterial endocarditis prophylaxis precautions, is not a primary concern in this scenario as the child has undergone complete repair of TOF, which reduces the risk of endocarditis. Prophylactic antibiotics are generally not recommended for these children unless there are specific circumstances warranting their use. Option D, teaching about management of hypercyanotic episodes, is also not the priority in this situation as children with TOF who have had complete repair are less likely to experience hypercyanotic episodes. It is important to focus on preventive care and promoting the child's overall health rather than managing acute complications that are less likely to occur post-repair. In an educational context, this question highlights the importance of understanding the long-term management and health maintenance needs of children who have undergone surgical repair of congenital heart defects like TOF. It emphasizes the role of the nurse practitioner in promoting the overall well-being of these children through appropriate health maintenance strategies tailored to their individual health status.
Question 2 of 5
A 10-year-old has undergone a cardiac catheterization. At the end of the procedure, the nurse should first assess:
Correct Answer: B
Rationale: In a pediatric patient who has undergone cardiac catheterization, the nurse's first assessment priority should be pulses (Option B). This is crucial because assessing pulses helps in evaluating the adequacy of circulation and detecting any potential complications such as vascular compromise or thrombosis post-procedure. Assessing pain (Option A) is important, but in this scenario, ensuring adequate perfusion takes precedence over pain assessment. Hemoglobin and hematocrit levels (Option C) are essential to monitor for potential bleeding complications, but this assessment would come after ensuring adequate perfusion by assessing pulses. Reviewing the catheterization report (Option D) is important for overall understanding of the procedure, but immediate post-procedure assessment of pulses is more critical for detecting any immediate issues. In an educational context, understanding the rationale behind prioritizing assessments in pediatric patients post-cardiac catheterization is vital for nurses caring for these patients. By recognizing the significance of assessing pulses first, nurses can provide prompt and appropriate interventions to ensure patient safety and optimal outcomes. This prioritization is based on the principles of pediatric cardiovascular nursing and critical thinking in assessing and managing post-procedural complications effectively.
Question 3 of 5
A child has been diagnosed with valvular disease following rheumatic fever (RF). During patient teaching, the nurse discusses the child's long-term prophylactic therapy with antibiotics for dental procedures, surgery, and childbirth. The parents indicate they understand when they say:
Correct Answer: D
Rationale: The correct answer is D) She will need to take the antibiotics for the rest of her life. This is because in cases of valvular disease following rheumatic fever, long-term prophylactic antibiotic therapy is required to prevent recurrent episodes of rheumatic fever and further damage to the heart valves. The American Heart Association guidelines recommend lifelong antibiotic prophylaxis for individuals with a history of rheumatic fever and valvular disease. This is crucial to prevent bacterial endocarditis, a serious infection of the heart valves. Option A) She will need to take the antibiotics until she is 18 years old is incorrect because the duration of antibiotic prophylaxis extends beyond the age of 18 in these cases. Option B) She will need to take the antibiotics for 5 years after the last attack and Option C) She will need to take the antibiotics for 10 years after the last attack are also incorrect as they suggest a limited duration of prophylactic therapy, which is insufficient to protect against potential complications. In an educational context, it is important for nurses and healthcare providers to educate patients and families about the necessity of lifelong antibiotic prophylaxis in cases of valvular disease following rheumatic fever. Reinforcing the importance of adherence to this therapy can help prevent serious cardiac complications and improve the patient's quality of life in the long term.
Question 4 of 5
An 18-month-old with a myelomeningocele is undergoing a cardiac catheterization. The mother expresses concern about the use of dye in the procedure. The child does not have any allergies. In addition to an iodine allergy, which other allergy should the nurse bring to the attention of the catheterization staff?
Correct Answer: B
Rationale: In this scenario, the correct answer is B) Latex. The rationale for this lies in the fact that children with myelomeningocele, a neural tube defect, are at increased risk for latex allergy. Latex is commonly found in medical equipment, including catheters, and exposure can lead to allergic reactions ranging from mild irritation to severe anaphylaxis. Option A) Soy, Option C) Penicillin, and Option D) Dairy are incorrect choices in this context. While allergies to these substances are possible in pediatric patients, they are not specifically associated with myelomeningocele or cardiac catheterization procedures. Educationally, it is crucial for nurses caring for pediatric patients with myelomeningocele to be aware of the increased risk of latex allergy and take appropriate precautions to prevent exposure. This knowledge ensures the safety and well-being of the child during invasive procedures like cardiac catheterization. Additionally, understanding the specific risks and considerations for this patient population enhances the nurse's ability to provide high-quality, individualized care.
Question 5 of 5
Exposure to which illness should be a cause to discontinue therapy and substitute dipyridamole (Persantine) in a child receiving aspirin therapy for Kawasaki disease (KD)?
Correct Answer: A
Rationale: In the case of a child receiving aspirin therapy for Kawasaki disease (KD), exposure to chickenpox or influenza should be a cause to discontinue therapy and substitute dipyridamole (Persantine). This is because aspirin therapy in the presence of a viral infection like chickenpox or influenza can increase the risk of Reye's syndrome, a rare but serious condition that affects the liver and brain. Option A is correct because both chickenpox and influenza are viral infections that can increase the risk of Reye's syndrome when aspirin is used concurrently. Option B (E. coli or staphylococcus) and Option D (Streptococcus A or staphylococcus) are incorrect as these bacterial infections do not pose the same risk in relation to aspirin therapy in KD. Option C (Mumps or streptococcus A) is also incorrect as mumps is a viral infection that, like chickenpox and influenza, can increase the risk of Reye's syndrome with aspirin therapy. Educationally, it is crucial for healthcare providers to be aware of the potential complications and interactions that can arise in pediatric pharmacotherapy, especially in conditions like KD where aspirin is a key component of treatment. Understanding the specific contraindications and risks associated with different infections and medications is essential for safe and effective patient care.