What does the surgical closure of the ductus arteriosus do?

Correct Answer: D

Rationale: The ductus arteriosus allows blood to flow from the higher-pressure aorta to the lower-pressure pulmonary artery, causing a right-to-left shunt. If this is surgically closed, no additional oxygenated blood (from the aorta) will return to the lungs through the pulmonary artery. The aorta carries oxygenated blood to the systemic circulation. Because of the higher pressure in the aorta, blood is shunted into the pulmonary artery and the pulmonary circulation. Edema in the legs and feet is usually a sign of heart failure. This repair would not directly affect the edema. Increasing the oxygenation of blood would not interfere with the return of oxygenated blood to the lungs.

Correct Answer: B

Rationale: In pediatric nursing, understanding the signs of digoxin toxicity is crucial as it is a common medication used in the management of cardiovascular disorders in children. The correct answer is B) Vomiting. Digoxin toxicity can present with gastrointestinal symptoms like vomiting, which can be an early indicator of an overdose. A) Seizures are not a common sign of digoxin toxicity in children. This symptom is more likely to be associated with other medication overdoses or conditions. C) Bradypnea (slow breathing) is not a typical sign of digoxin toxicity. In contrast, digoxin toxicity is more likely to manifest with respiratory distress or other cardiac-related symptoms. D) Tachycardia (rapid heartbeat) is actually a common therapeutic effect of digoxin rather than a sign of toxicity. In cases of digoxin toxicity, bradycardia (slow heartbeat) is more commonly observed due to the drug's effects on the heart's conduction system. Educationally, it is essential for nurses and parents to be aware of the signs and symptoms of digoxin toxicity to ensure early detection and prompt intervention. Teaching parents about these signs empowers them to monitor their child's condition closely and seek medical help if they notice any concerning symptoms, ultimately contributing to the safe management of their child's cardiovascular disorder.

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: C

Rationale: If evidence is noted of cardiac tamponade, which is blood or fluid in the pericardial space constricting the heart, the physician is notified immediately of this life-threatening complication. Increasing analgesia may be done before the physician drains the fluid, but the physician must be notified. Warming blankets are not indicated at this time. Encouraging the child to cough, turn, and breathe deeply should be deferred till after the evaluation by the physician.

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.