Pediatric Virtual Hospital

A two-month-old is showing signs and symptoms of heart failure. An echocardiogram is ordered. The test shows the infant has ventricular septal defect (VSD). Which statement below best describes the blood flow in the heart due to this congenital heart defect.

• "The blood in the heart is shunting from the right ventricle to the left ventricle, which is increasing pulmonary blood flow."

• "The blood in the heart is shunting from the left ventricle to the right ventricle, which is decreasing pulmonary blood flow."

• "The blood in the heart is shunting from the left ventricle to the right ventricle, which is increasing pulmonary blood flow."

• "The blood in the heart is bypassing the left ventricle and is being shunted to the right ventricle, which is decreasing lung blood flow."

A small muscular ventricular septal defect has a high probability of self-closure, and these types of VSD are found in the lower portion of the ventricular septum.

• True

• False

A concerned mother brings her 3-month-old to the clinic. The mother states the infant seems to be small for its age. While collecting a through health history, what other signs and symptoms described by the mother may indicate the child has a congential heart defect, such as a VSD. Select all that apply:

• Diarrhea

• Frequent treatment of lung infections

• Excessive wet diapers

• Diaphoresis when nursing

• Swelling in hands and feet

The signs and symptoms of ventricular septal defect are most commonly detected in a baby following birth:

• True

• False

A 4-month-old is scheduled to take Digoxin for treatment of a VSD. The patient's apical pulse is 89 beats per minute. As the nurse what will you do: (select all that apply):

• Hold the dose

• Recheck the pulse via the brachial artery

• Administer the dose as scheduled

• Notify the physician

A baby, exhibiting no obvious symptoms of congestive heart failure has been diagnosed with a small ventricular septal defect. Which of the following information should the nurse explain to the baby's parents.

• The baby will most likely need open heart surgery with a week

• The defect will likely close without therapy

• The defect likely developed early in the second trimester

• The baby will likely be placed on a high-calorie formula

A 10-month-old infant was seen in the Emergency Department for respiratory distress is admitted to the pediatric unit with a diagnosis of bronchiolitis. Which of these if assessed, alerts the healthcare provider the bronchiolitis is worsening?

• Head bobbing

• Inspiratory stridor

• Drooling

• Pleurtic chest pain

While caring for an infant with a diagnosis of bronchiolitis, the healthcare provider notices audible grunting sounds during the infant's respirations. How should the healthcare provider interpret the grunting in relation to the infant's respiratory status?

• Oxygen consumption is decreased with grunting which helps to resolve hypoxemia

• During grunting lung volume increases as more air moves through the conducting airways

• Grunting increases end expiratory pressure and promotes gas exchange

• During grunting the diameter of the bronchi and bronchioles is increased

Please choose the best sequence of retraction landmarks as labeled in the picture:

• Intercostal, Subcostal, Substernal, Supraclavicular

• Supraclavicular, Substernal, Intercostal, Subcostal

• Intercostal, Supraclavicular, Substernal, Subcostal

• Subcostal, Intercostal, Supraclavicular, Substernal

Which medication when given by G-tube should be given 1 hour before feeds or 2 hours after feeds?

• Phenobarbital

• Acetaminophen

• Phenytoin

• Ibuprofen