What should the nurse assess prior to administering digoxin? (Select all that apply.)

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: 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.

Correct Answer: B

Rationale: In this question, the correct answer is B) coarctation of aorta, as it is not a common cause of heart failure in full-term neonates. Coarctation of the aorta typically presents with symptoms related to decreased lower extremity pulses rather than heart failure in neonates. Option A) asphyxial can lead to hypoxia and subsequent heart failure in neonates due to inadequate oxygen supply. Option C) hypoplastic left heart syndrome and option D) transposition of great arteries are congenital heart defects that can result in heart failure in full-term neonates due to structural abnormalities affecting the heart's ability to pump effectively. In an educational context, understanding the various causes of heart failure in neonates is crucial for nurses caring for pediatric patients. Recognizing these conditions early can lead to prompt intervention and improved outcomes for neonates with cardiovascular conditions. Nurses should be knowledgeable about common cardiac defects and their associated presentations to provide optimal care and support to neonates and their families.

Correct Answer: D

Rationale: In this question, the correct answer is D) sepsis. Sepsis is a condition that can lead to congestive heart failure and cardiomegaly in newborns without causing a murmur. This is because sepsis can result in myocardial dysfunction and impaired cardiac function, leading to these cardiac manifestations. A) Endocardial fibroelastosis is a condition that can present with congestive heart failure and cardiomegaly in newborns, often accompanied by a murmur due to thickening of the endocardium. B) Asphyxia can also result in congestive heart failure and cardiomegaly in newborns, usually with associated murmurs due to hypoxic damage to the heart muscle. C) Glycogen storage disease (Pompe disease) can lead to cardiac hypertrophy and heart failure in newborns, typically associated with murmurs due to the structural changes in the heart muscle. Educational context: Understanding the causes of congestive heart failure and cardiomegaly in newborns is crucial for pediatric healthcare providers to promptly diagnose and manage these conditions. Recognizing the different etiologies and associated clinical manifestations, including the presence or absence of murmurs, is essential for providing optimal care to newborns with cardiovascular conditions.