Which congenital cardiac defect(s) cause(s) increased pulmonary blood flow? (Select all that apply.)

Correct Answer: D

Rationale: In pediatric cardiovascular disorders, understanding congenital cardiac defects and their impact on blood flow is crucial for nurses caring for these patients. In this scenario, the correct answer is D) Patent ductus arteriosus (PDA), as it causes increased pulmonary blood flow. A) Atrial septal defects (ASDs) typically result in a left-to-right shunt, causing increased blood flow from the left atrium to the right atrium. This leads to volume overload on the right side of the heart but does not specifically increase pulmonary blood flow. B) Tetralogy of Fallot is characterized by a ventricular septal defect, overriding aorta, pulmonary stenosis, and right ventricular hypertrophy. It results in decreased pulmonary blood flow due to the obstruction of blood flow to the lungs. C) Dextroposition of the aorta refers to the aorta being positioned more to the right than normal but does not directly cause increased pulmonary blood flow. Understanding the underlying pathophysiology of each cardiac defect is essential for nurses to provide appropriate care and interventions. Nurses need to recognize the signs and symptoms of increased pulmonary blood flow in patients with PDA to prevent complications such as pulmonary hypertension and heart failure. Education on these concepts ensures nurses can deliver safe and effective care to pediatric patients with congenital cardiac defects.

Correct Answer: B

Rationale: In pediatric patients, maintaining fluid and electrolyte balance is crucial for overall health and well-being. Option B, stating that a fluid deficit of 50ml/kg produces a body weight loss of 10%, is correct. This is because dehydration in children can lead to significant weight loss, making it a reliable indicator of fluid imbalance. Option A is incorrect because the normal maintenance requirement in a child weighing 20 kg is approximately 1,000 ml (50 ml/kg/day), not 1.5 liters/day, which would be excessive for a child of this weight. Option C is incorrect because hypotension is a late and severe sign of dehydration, not moderate dehydration. Earlier signs include tachycardia, decreased urine output, and dry mucous membranes. Option D is incorrect as the normal maintenance needs of sodium for a child are around 2-3 mmol/kg/day, not 5-6 mmol/kg/day. Excessive sodium intake can lead to hypernatremia and other complications. In an educational context, understanding fluid and electrolyte balance in pediatric patients is essential for nurses caring for children with cardiovascular disorders. Proper assessment and management of dehydration are critical skills to prevent complications and promote optimal health outcomes in pediatric patients.

Correct Answer: D

Rationale: In the context of pediatric cardiovascular disorders nursing, understanding the impact of urinary tract infections (UTIs) is crucial as they can lead to serious complications. The correct answer, D, "Is associated with constipation," is the most appropriate choice because constipation can contribute to UTIs in children by causing a backup of urine, leading to bacterial overgrowth and infection in the urinary tract. Option A, "Usually leads to vesico-ureteric reflux," is incorrect because while UTIs can sometimes be associated with vesico-ureteric reflux, it is not a universal outcome of UTIs. Option B, "Is more common in boys than girls under a year of age," is incorrect. UTIs are actually more common in girls, especially in the first year of life, due to anatomical differences that make them more susceptible to infections. Option C, "In boys, is most commonly caused by Proteus mirabilis," is also incorrect. While Proteus mirabilis is a common cause of UTIs in boys, it is not the most common pathogen responsible for UTIs in this population. Educationally, it is important for nursing students to recognize the risk factors and common etiologies of UTIs in pediatric patients to provide appropriate care and prevent complications. Understanding the relationship between constipation and UTIs can help nurses implement preventive measures and early interventions to improve patient outcomes.

Correct Answer: D

Rationale: Rett syndrome is a rare genetic disorder that primarily affects girls and leads to severe impairments in motor, cognitive, and social functioning. The correct answer is D) Wringing hand movements. This is a classic feature of Rett syndrome, where affected individuals show repetitive, stereotyped hand movements such as wringing, clapping, or tapping. Option A) Social withdrawal is not typically a defining feature of Rett syndrome. While individuals with Rett syndrome may experience social difficulties, the hallmark symptoms are more related to motor function. Option B) Self-mutilation can occur in some cases of Rett syndrome but is not as characteristic as the hand-wringing movements seen in these individuals. Option C) Macrocephaly, or abnormally large head size, is not typically associated with Rett syndrome. In fact, individuals with Rett syndrome often have normal head size or even microcephaly. In an educational context, understanding the specific clinical manifestations of Rett syndrome is crucial for healthcare professionals, especially nurses caring for pediatric patients. By recognizing the key features of the syndrome, healthcare providers can facilitate early diagnosis, appropriate interventions, and supportive care for individuals with Rett syndrome and their families. This knowledge enhances the quality of care provided and contributes to improved outcomes for these vulnerable patients.

Correct Answer: A

Rationale: In the context of pediatric cardiovascular disorders, the correct answer is option A) Oxygen saturation in the hand is 80% and in the foot 67% for diagnosing primary pulmonary hypertension of the newborn. This is indicative of a significant difference in oxygen saturation between the upper and lower extremities, known as a "step-up" in oxygen saturation, which is a hallmark sign of this condition. Option B) A tachypnoeic baby with a saturation of 60% is not specifically indicative of primary pulmonary hypertension of the newborn. While low oxygen saturation and tachypnea can be present in this condition, the key differentiator is the discrepancy in saturation between the upper and lower limbs. Option C) A baby with a history of meconium aspiration syndrome having a PaO2 of 4kPa is more suggestive of respiratory distress syndrome due to meconium aspiration rather than primary pulmonary hypertension of the newborn. Option D) A septic baby being hypoxic in 100% oxygen is more likely to have hypoxemia due to sepsis rather than primary pulmonary hypertension of the newborn. In an educational context, understanding the specific clinical presentations and diagnostic criteria for pediatric cardiovascular disorders is crucial for accurate assessment and timely intervention. Recognizing the unique signs and symptoms of conditions like primary pulmonary hypertension of the newborn can lead to prompt diagnosis and appropriate management, improving patient outcomes.