NUR392- Cardiovascular

The nurse is caring for a child with suspected heart arrhythmia. The child will wear an ambulatory electrocardiograph monitor for 24 hours. What is the most important instruction for the nurse to give the child and parent during monitoring?

• how and when to use the event button

• importance of keeping the electrodes dry and intact

• the need for rest frequently during monitoring

• why the child will continue to take any scheduled medications during monitoring

A 3-year-old child is postoperative from a cardiac surgery. Which assessment finding(s) by the nurse warrants immediate action? Select all the apply.

• cessation of chest tube drainage

• heart rate increase from 88 to 136 beats/min

• report of pain with movement of 6 out of 10 on numeric scale

• drainage on the chest dressing

• apical heart rate strong and easily auscultated

The nurse is caring for a 3-month-old infant with history of congenital heart disease. The infant is brought to the emergency department with nausea and vomiting for 3 days. Admission laboratory results confirm dehydration. The nurse realizes that the dehydrated infant is at risk for:

• seizure activity.

• tachycardia.

• a cerebrovascular accident (stroke).

• jaundice.

The nurse is caring for a child admitted to the hospital for a cardiac catheterization. Upon return from the cardiac catheterization, which nursing action is priority?

• Assess the dressing at the insertion site.

• Maintain patency of intravenous access.

• Apply blood pressure monitor.

• Palpate for pulses in bilateral extremities.

The nurse is implementing the plan of care for a child with acute rheumatic fever. What treatment(s) would the nurse expect to administer if prescribed? Select all that apply.

• penicillin

• corticosteroids

• nonsteroidal anti-inflammatory drugs

• digoxin

• intravenous immunoglobulin

After a cardiac catheterization, the nurse monitors the child's fluid balance closely based on the understanding that:

• the contrast material used has a diuretic effect.

• blood loss during the procedure can be significant.

• the insertion of the catheter into the heart stimulates a diuretic response.

• the prolonged preprocedure fasting state places the child at risk for dehydration.

A nurse is reviewing the medical record of a child and finds that the child has a grade III murmur. After auscultating the child's heart sounds, how would the nurse document this murmur?

• loud without a thrill

• loud with a precordial thrill

• soft and easily heard

• loud, audible with a stethoscope

The nurse is teaching the parents of a child with congenital heart disease about clubbing. Which statement by the parents demonstrates a need for further teaching?

• "If clubbing is noted, we should administer oxygen to our child immediately."

• "One of the first signs of clubbing we will see is the nail beds becoming softer."

• "We may notice a rounding then thickening of the nail beds."

• "Clubbing may result due to our child having chronically low oxygen levels."

When caring for a child who has just had a cardiac catheterization, what is a sign of hypotension?

• cold, clammy skin and increased heart rate

• decreased heart rate and dizziness

• syncope and tachypnea

• diaphoresis and tachycardia

The nurse is taking a health history of a toddler with a suspected congenital heart defect. Which response by the mother could indicate that the child is experiencing hypercyanotic spells?

• "He likes to stop and squat wherever he walks."

• "He walks very quickly and never stops moving."

• "He takes one nap a day and is fairly active."

• "He does not seem to have difficulty breathing."