Which statement by a parent of an infant with congestive heart failure (CHF) who is being sent home on digoxin indicates the need for further education?

Correct Answer: D

Rationale: The correct answer is D) "I will mix the digoxin in some formula to make it taste better." This statement indicates the need for further education because digoxin should not be mixed with food as it can affect the absorption and effectiveness of the medication. It is important to administer digoxin on an empty stomach to ensure proper absorption and consistent blood levels. Option A) "I will give the medication at regular 12-hour intervals" is correct as digoxin should be administered at regular intervals to maintain therapeutic levels in the body. Option B) "If he vomits, I will not give a make-up dose" is also correct because administering a double dose due to vomiting can lead to overdose and toxicity. Option C) "If I miss a dose, I will not give an extra dose" is correct since doubling the dose to make up for a missed one can result in digoxin toxicity. Educationally, it is crucial to emphasize to parents the proper administration techniques for medications, especially in pediatric patients with CHF. Providing clear instructions on medication administration can prevent errors and ensure the child's safety and treatment effectiveness. It is important for parents to understand the rationale behind each instruction to promote adherence to the treatment plan and optimize the child's health outcomes.

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.

Correct Answer: B

Rationale: In pediatric nursing, understanding signs of coarctation of the aorta is critical. The correct answer is B) bounding pulses of the arms. This is because coarctation of the aorta typically presents with weak or absent femoral pulses (option A), lower blood pressure in the legs compared to the arms (option C), and usually normal precordial impulse and heart sounds (option D). Bounding pulses in the arms are not a typical sign of coarctation of the aorta. This is due to the narrowing of the aorta that results in decreased blood flow to the lower extremities, leading to weaker pulses in the femoral arteries. Understanding these signs is important for nurses caring for pediatric patients as early recognition of coarctation of the aorta can lead to prompt intervention and management to prevent complications. Educationally, nurses need to be able to differentiate between the various signs and symptoms of cardiovascular conditions in pediatric patients to provide safe and effective care. By understanding the unique manifestations of coarctation of the aorta, nurses can advocate for appropriate diagnostic testing and interventions to improve patient outcomes.