Spring 2535 ox-circ

Which medication is commonly used to manage patent ductus arteriosus (PDA) in premature infants?

• Asprin

• Digoxin

• Indomethacin

• Metoprolol

Answer explanation

Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) often used to close a PDA in premature infants by inhibiting prostaglandin synthesis.

Which clinical manifestation is commonly associated with patent ductus arteriosus in infants?

• Cyanosis

• Bradycardia

• Machine-like murmur

• Hypertension

Answer explanation

A murmur is commonly associated with patent ductus arteriosus (PDA). This murmur typically manifests as a continuous "machinery" murmur heard best at the left upper sternal border due to the continuous flow of blood from the aorta to the pulmonary artery.

The nurse is educating the parents of an infant diagnosed with patent ductus arteriosus (PDA). Which statement by the parents indicates a need for further teaching?

• "We should monitor for signs of respiratory distress in our baby"

• "We will need to restrict our baby's fluid intake"

• "Our baby may require a surgical procedure to close the ductus arteriosus"

• "It's important to attend all follow-up appointments with the pediatric cardiologist"

Answer explanation

Restricting fluid intake is not indicated in the management of PDA. Adequate hydration is important, especially in infants with heart defects.

A nurse is caring for an infant with a large atrial septal defect (ASD). Which assessment finding is consistent with this condition?

• Clubbing of the fingers

• Widened pulse pressure

• Diminished femoral pulses

• Increased pulmonary artery pressure

Answer explanation

In a large atrial septal defect (ASD), there is increased blood flow from the left atrium to the right atrium, leading to increased blood volume and pressure in the right heart chambers. This results in increased pulmonary artery pressure as the right ventricle works harder to accommodate the increased volume of blood.

During an assessment of a 6-month-old infant, the nurse detects a fixed split second heart sound upon auscultation. Which condition does this finding most likely indicate?

• Ventricular septal defect

• Tetralogy of Follot

• Atrial Septal defect

• Coarctation of the aorta

Answer explanation

A fixed split second heart sound, where the timing between the closure of the aortic and pulmonary valves remains constant regardless of respiratory phase, is characteristic of atrial septal defect (ASD). This occurs due to increased blood flow through the right side of the heart. Ventricular septal defect (VSD) typically presents with a loud, harsh holosystolic murmur. Tetralogy of Fallot (TOF) presents with a loud, single second heart sound and a systolic ejection murmur. Coarctation of the aorta presents with differences in blood pressure and pulse volume between the upper and lower extremities.

A nurse is caring for a child diagnosed with an atrial septal defect (ASD). Which symptom is the child most likely to exhibit?

• central cyanosis

• digital clubbing

• soft systolic murmur

• dyspnea on exertion

Answer explanation

In atrial septal defect (ASD), a left-to-right shunt allows oxygenated blood from the left atrium to flow into the right atrium, leading to increased pulmonary blood flow. Dyspnea on exertion is a common symptom due to the increased pulmonary blood flow and volume overload on the right side of the heart. Central cyanosis, digital clubbing, and a systolic murmur at the left sternal border are more characteristic of other congenital heart defects

A nurse is assessing a newborn suspected of having a ventricular septal defect (VSD). Which clinical manifestation is most indicative of this condition?

• cyanosis during feeding

• hyperactive bowel sounds

• a harsh, holosystolic murmur at the left sternal border

• clubbing of the fingers

Answer explanation

A ventricular septal defect (VSD) typically presents with a harsh, holosystolic murmur heard best at the left sternal border due to the turbulent blood flow between the ventricles. Cyanosis during feeding may occur in other congenital heart defects, but it is not specific to VSD. Hyperactive bowel sounds and clubbing of the fingers are not typically associated with VSD.

A nurse is providing discharge teaching to the parents of an infant with a ventricular septal defect (VSD). Which instruction is appropriate for the parents?

• "Limit your baby's fluid intake to avoid heart failure"

• "Avoid taking your baby to crowded places to prevent infections"

• "Monitor your baby for signs of decreased urine output"

• "Position your baby flat on the back during sleep"

Answer explanation

Infants with ventricular septal defects (VSD) are at increased risk of respiratory infections due to possible pulmonary congestion. Therefore, avoiding crowded places can help reduce the risk of infections. Limiting fluid intake, monitoring urine output, and positioning the baby flat on the back during sleep are not specifically related to managing VSD.

A nurse is assessing a newborn with a suspected ventricular septal defect (VSD). Which finding would the nurse expect during the assessment?

• peripheral cyanosis

• loud, blowing diastolic murmur

• diminished femoral pulses

• poor weight gain and failure to thrive

Answer explanation

Ventricular septal defects (VSDs) typically result in increased pulmonary blood flow and may lead to poor weight gain and failure to thrive due to the increased workload on the heart. Peripheral cyanosis, a loud, blowing diastolic murmur, and diminished femoral pulses are not typical findings of VSD.

A nurse is assessing a 4 year old suspected of having Tetralogy of Fallot (TOF). Which characteristic finding would the nurse expect to observe?

• clubbing of the fingers

• fixed split S2 heart sound

• loud systolic ejection murmur

• hyperactive bowel sounds

Answer explanation

Clubbing of the fingers is a characteristic finding in Tetralogy of Fallot (TOF) due to chronic hypoxemia. It occurs as a result of long-standing low oxygen levels in the blood. The other options are not typically associated with TOF.