Which finding might delay a cardiac catheterization procedure on a 1-year-old?

Correct Answer: B

Rationale: In the context of a pediatric nursing cardiovascular NCLEX practice quiz, the correct answer to the question, "Which finding might delay a cardiac catheterization procedure on a 1-year-old?" is option B) Severe diaper rash. Rationale: Severe diaper rash can delay a cardiac catheterization procedure in a 1-year-old due to the risk of infection. Performing a cardiac catheterization involves inserting a catheter through the skin into blood vessels, which can introduce bacteria and increase the risk of infection. Therefore, it is crucial to ensure that the skin is free from any open wounds or infections before proceeding with the procedure. Option A) 30th percentile for weight is not a contraindication for cardiac catheterization. While weight can be a factor in determining medication dosages or equipment sizes, it alone would not usually delay the procedure. Option C) Allergy to soy is also not directly related to delaying a cardiac catheterization procedure unless the contrast medium used during the procedure contains soy, which can be easily substituted with a different contrast medium if needed. Option D) Oxygen saturation of 91% on room air is slightly lower than the normal range but is not significantly low enough to typically delay a cardiac catheterization procedure. Oxygen supplementation can be provided if necessary during the procedure to maintain adequate oxygenation. Educational Context: Understanding the factors that can impact procedural readiness in pediatric patients is crucial for nurses and healthcare providers. In this scenario, recognizing the potential complications of performing a cardiac catheterization in the presence of severe diaper rash highlights the importance of maintaining skin integrity to prevent infections and ensure optimal patient outcomes. This knowledge is essential for providing safe and effective care to pediatric patients undergoing cardiac procedures.

Correct Answer: B

Rationale: In pediatric patients with congenital heart defects (CHD) characterized by decreased pulmonary blood flow, such as Tetralogy of Fallot, the nurse would expect to see polycythemia as a laboratory finding. Polycythemia is the body's compensatory mechanism to increase red blood cell production in response to chronic hypoxia, which is common in CHD patients with decreased pulmonary blood flow. The increased red blood cell count helps improve oxygen-carrying capacity in an attempt to meet the body's oxygen demands. Regarding the other options: A) Decreased platelet count: This is not typically associated with CHD of decreased pulmonary blood flow. Platelet count is more related to clotting disorders or certain medications. C) Decreased ferritin level: Ferritin is a marker for iron storage in the body and is not directly related to the pathophysiology of CHD with decreased pulmonary blood flow. D) Shift to the left: This term refers to an increase in immature white blood cells and is usually seen in cases of infection or inflammation, not specifically in CHD patients with decreased pulmonary blood flow. Understanding these laboratory findings in the context of pediatric patients with CHD is crucial for nurses caring for these vulnerable populations. Monitoring laboratory values helps in assessing the patient's response to treatment and identifying any complications early on. It also aids in providing holistic care tailored to the individual needs of each pediatric patient with a congenital heart defect.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) tetralogy of Fallot. Left ventricular hypertrophy with a superior QRS axis typically indicates right ventricular hypertrophy, a common finding in tetralogy of Fallot due to the right ventricular outflow tract obstruction. This condition leads to unequal pressures between the right and left ventricles, causing the left ventricle to become hypertrophied. Option A) tricuspid atresia is incorrect because it typically presents with right axis deviation on ECG due to right ventricular hypertrophy. Option B) Ebstein anomaly is incorrect as it is characterized by a low voltage QRS complex and right axis deviation on ECG. Option C) pulmonary atresia is incorrect as it would show right axis deviation on ECG due to right ventricular hypertrophy. Educationally, understanding the ECG findings in different congenital heart defects is crucial for pediatric nurses to provide appropriate care and interventions. Recognizing specific ECG patterns can aid in the early identification of potential cardiac issues in pediatric patients, leading to timely interventions and improved outcomes.

Correct Answer: B

Rationale: In pediatric nursing, understanding cardiovascular disorders like coarctation of the aorta is crucial. The correct answer for the most common clinical sign of coarctation of the aorta in older children being notching of the inferior border of the ribs (Option B) is due to the pathophysiology of this condition. Coarctation of the aorta causes a narrowing of the aorta, leading to increased pressure proximal to the constriction and decreased pressure distally. This pressure difference results in collateral circulation formation, which leads to rib notching due to dilated intercostal arteries. Option A, cardiac enlargement, is less common in coarctation of the aorta compared to other congenital heart defects. Option C, a systolic ejection click or thrill in the suprasternal notch, is more indicative of aortic stenosis. Option D, differential blood pressure with higher readings in the arms than the legs, is a classic finding in coarctation of the aorta but is not as specific or commonly seen as rib notching. Educationally, it is essential for nursing students to grasp the unique clinical manifestations of different cardiovascular conditions to provide accurate assessments and interventions. Understanding the specific signs and symptoms of coarctation of the aorta aids in timely diagnosis and management, ultimately improving patient outcomes.

Correct Answer: B

Rationale: Kawasaki disease is an acute febrile illness that primarily affects children. The correct answer is B) first-degree heart block is not strongly associated with Kawasaki disease. A) Duration of fever of >16 days is associated with Kawasaki disease because prolonged fever is a common symptom of the condition. C) Male gender is a risk factor for Kawasaki disease as it is more commonly seen in boys than girls. D) Age of <1 year is a risk factor for Kawasaki disease, as children under the age of 1 are more susceptible to developing the condition. Educationally, understanding the clinical manifestations and risk factors associated with Kawasaki disease is crucial for pediatric nurses to recognize and provide timely intervention. By knowing the typical presentations and characteristics of the disease, nurses can facilitate early diagnosis and management, ultimately improving patient outcomes.