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174 Cards in this Set
- Front
- Back
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Thiazolidinediones and alpha-glucosidase inhibitors require the monitoring of ___.
a) renal function b) liver function c) sodium d) potassium |
b) liver function
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Renal function needs to be monitored in patients taking what oral antidiabetic medication?
a) sulfonylurea b) biguanides c) thiazolidinediones d) alpha-glucosidase inhibitors |
b) biguanides
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How many steps per day are recommended for exercise for diabetics?
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10,000
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A patient has a bg of 257. The doctor orders 6 units of regular insulin according to the sliding scale, and 12 units of Lantus. How should the nurse draw up and administer the insulin?
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The nurse needs to draw up the regular insulin in one syringe and the lantus in a second syringe. The two cannot be mixed
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What is it called when new, bleeding prone, blood vessels grow from the retina into the vitreous?
a) hypervascularization b) hypovascularization c) proliferative retinopathy d) non-proliferative retinopathy |
c) proliferative retinopathy
*Remember proliferate means to grow! |
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What are the 3 stages, in order, of retinopathy?
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1. Non-proliferative
2. Pre-proliferative 3. Proliferative |
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What is a vitrectomy?
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When the vitreous humor that is filled with blood or fibrous tissue is removed and replaced with saline
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True or False: Vitrectomies allow patients to return to near normal vision.
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False: Near normal vision is not usually expected. What can be expected is the restoration of useful vision. I.E vision is improved but it will never be perfect.
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What complication of diabetes involves Kussmaul respirations?
a) hypoglycemia b) DKA c) HHNS |
b) DKA
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Intermittent claudication is related to:
a) arterial disease b) venous disease |
a) arterial disease
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What would you recommend to the patient to enhance arterial blood supply?
a) elevate the legs b) lower the legs c) keep the legs straight d) ice the legs |
b) lower the legs to the depended position to improve perfusion to the distal tissues
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Pain characterized by aching and cramping is:
a) venous b) arterial |
a) venous
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Legs that are reddish blue have arterial or venous insufficiency?
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venous
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Skin that is cool, with loss of hair over the toes and dorsum of the foot is classic of venous or arterial insufficiency?
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arterial
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Does arterial or venous insufficiency cause the most pain?
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arterial
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Do arterial or venous ulcers have an irregular border?
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venous
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Do venous or arterial ulcers have a beefy red to yellow fibrinous granulation tissue?
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venous
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Do venous or arterial ulcers have pale to black ulcer bases?
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arterial
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What is rubor and what does it indicate?
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Rubor is a reddish-blue discoloration of the extremities that can be observed within 20 seconds to 2 minutes ofter an extremity is placed in the dependent position: it suggest severe arterial damage
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How is the patient best positioned for evaluation of the lower extremities?
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supine with HOB elevated 20-30 degrees
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To listen to blood flow, the doppler is positioned at a ___ angle over the expected location of the artery.
a) 10-15 b) 20-30 c) 45-60 d) 90 |
c) 45-60
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True or false: Arterial blood supply is enhanced by allowing your feet to rest on the floor.
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True
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True or False, for the patient with arterial insufficiency, the nurse instructs the patient to walk to the point of pain, rest until the pain subsides and then resume walking.
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True
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To enhance tissue perfusion, how should the legs be positioned?
a) raised b) lowered c) level with the heart |
b) lowered
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If vascular conditions are venous in nature, how should the legs be positioned?
a) elevated b) lowered c) heart level |
a) elevated- to promote venous return
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A person with peripheral vascular problems would be recommended to avoid:
a) smoking b) alcohol c) muscle relaxers d) leg massages |
a) smoking- it causes vasospasm and can thereby dramatically reduce circulation to the extremities
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What nutrients are specific to wound healing?
a) vitamin A,C,E b) zinc, Vitamin A, E c) Vitamin A, C, zinc d) Vitamin B, B12, E |
c) Vitamin A, C, zinc
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True of False: The patient complaining of arterial leg pain should elevate and ice their leg to reduce pain.
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False, put the leg in the dependent position
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Pentoxifylline (Trental) and Cilostazol (Pletal) are the only 2 medications specifically indicated for the treatment of:
a) varicose veins b) venous insufficiency c) intermittent claudication d) dependent edema |
c) intermittent claudication
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What is the primary focus of assessment for the nurse during the post-operative assessment of the patient who underwent a vein graft for peripheral arterial occlusive disease?
a) lung sounds b) oxygen saturation c) urinary output d) assessing pulses |
d) assessing pulses including sensory and motor function of the affected extremity; these are compared with those of the unaffected extremity
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True or False: Edema is a normal postoperative finding after a vein graft.
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True, however, elevating the extremities and encouraging the patient to exercise the extremities while in bed reduces edema
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What autoimmune disease results in the occlusion of distal vessels due to recurring inflammation of the intermediate and small arteries and veins of the lower and (in rare cases) upper extremities?
a) Buerger's disease b) varicose veins c) intermittent claudication d) chronic peripheral venous insufficiency(CPVI) |
a) Buerger's disease
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What is the outstanding complaint of those with Buerger's disease?
a) tired legs b) swollen feet c) pain d) pins and needles feeling in the legs |
c) pain- particularly after exercise
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Who is most at risk for an abdominal aortic aneurysm?
a) men b) women c) nurses d) air traffic controllers |
a) men- 4x the risk than women
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What are signs and symptoms of an abdominal aortic aneurysm?
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pulsating abdominal mass, may be painful, may cause thrombi
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A person with a known aneurysm suddenly develops intense back pain, has a dropping Hematocrit and falling blood pressure. What has likely happened?
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a ruptured aneurysm
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True or False: Most people (75%) survive a ruptured aneurysm?
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False: 50-75% die
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What is the postoperative activity for a patient who underwent an endovascular surgical repair?
a) activity as tol b) bed rest for 24 hours c) bed rest for 6 hours d) up to a chair with assistance only |
c) bed rest for 6 hours- then the patient may raise the HOB 45 degree 2 hours into the bed rest
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Cocaine use has been known to cause ___.
a) aneurysms b) VSD c) ASD d) dissecting aorta |
d) dissecting aorta- can be caused by cocaine use as well as poorly controlled hypertension and blunt chest trauma
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What is a patient started on immediately following identification of an arterial thrombosis?
a) streptopase b) coumadin c) heparin d) aspirin |
heparin- bolus of 5000-10000 units and then IV 1000 per hour until surgery
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A patient is preparing for surgery to remove an arterial thrombus. How should the patient should be positioned while awaiting surgery?
a) bed rest with extremity lowered 15 degrees b) bed rest with extremity elevated c) bed rest with a heating pad on effected extremity d) bed rest with a cooling pad on effected extremity |
a) bed rest with effected leg in the dependent position, 15 degrees lowered
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What postoperative activity instructions are given to the patient who underwent a thrombus removal?
a) bed rest for 6 hours b) bed rest for 24 hours c) as much movement as possible d) no recommendations are given, the patient may do whatever causes the least amount of pain |
c) as much movement as possible-this helps stimulate circulation and prevent stasis
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A patient who report coldness, pain, and pallor of the fingertips or toes is most likely suffering from what disease?
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Raynaud's disease
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Who is most likely to get Raynaud's disease?
a) a 70 year old man b) a 30 year old man c) a 70 year old woman d) a 30 year old woman |
d) a 30 year old woman- women ages 16-40 are most at risk
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What is the characteristic sequence of color in Raynaud's disease?
a) tan, red, blue b) blue, tan, red c) red, blue, white d) white, blue, red |
d) white, blue, red
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A person with Raynaud's disease would be recommended to avoid:
a) smoking b) muscle relaxers c) benzodiazapines d) Digoxin |
a) smoking: or anything that causes vasoconstriction(cold)
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True or False: A patient with Raynaud's disease should be sure to wear gloves in the winter because of their high risk of getting gangrene and amputation.
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False: Those are rare complications!
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True or False: Homans' sign( pain in the calf after the foot is sharply dorsiflexed) is a specific test for a DVT.
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False: it is not specific for DVTs because it can be elicited in any painful condition of the calf.
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What medication can be given to pregnant women with a DVT?
a) heparin b) coumadin c) aspirin d) Lovenox |
d) Lovenox
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How long after a DVT is discovered can thrombolytic medication be effectively given ?
a) 4 hours b) 3 days c) 1 week d) no time limit, it is always effective |
b) it is most effective when given within 3 hours of onset of pain
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What are possible adverse effects to protamine sulfate?
a) cough b) epitaxis c) hypotension/bradycardia d) hypertension/tachycardia |
c) hypotension/bradycardia
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Lepirudin (Refludan) and Argatroban are indicated for what condition related to heparin administration?
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HIT: Heparin induced thrombocytopenia
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True or False: In a patient who has an identified venous thrombosis, it is recommended that they ambulate frequently to maintain circulation to the tissue distal to the blood clot.
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False: Bed rest is required for 5-7 days following identification of the thrombus to give it time to adhere to the vein wall and prevent embolization!
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When applying elastic stockings:
a) apply them in bed before getting up b) sit up in a chair and put them on c) if they are too long, roll the top down to a comfortable height d) ensure that the stocking is tightest around the calf, and loosest around the ankle |
a) apply them in bed before getting up: all the other are things you SHOULDN'T do
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Do venous or arterial ulcers usually occur in pressure areas?
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arterial
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Would debridement be recommended in a patient with arterial insufficiency who has a gangrenous toe?
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No, because it will leave an open wound that will not heal!
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Aquacel, a calcium alginate dressing is applied to:
a) dry wounds b) wet wounds c) highly infected wounds d) arterial wounds |
b) wet wounds- they absorb exudate and turn to gel that can be removed
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Why would aquacel be used on a painful wound?
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It turns to gel as it absorbs exudate and can be painlessly removed.
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Who are most likely to get varicose veins? Check all that apply:
a) bank tellers b) dental hygienists c) nurses d) teachers |
a) bank teller
c) nurses d) teacher All these people spend a lot of time standing! |
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What test is used to diagnose varicose veins?
a) doppler b) x-ray c) duplex scan d) no diagnostic test exists |
c) duplex scan
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A patient who underwent thermal abrasion is recommended to leave the postoperative compression stocks on for ____.
a) 1-2 hours b) 48 hours c) 1 week d) 2 weeks |
b) 48 hours
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What activity restrictions do people have following thermal ablation?
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None, except no swimming for 3 weeks
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Following sclerotherapy, how long must the elastic compression bandages be worn?
a) 1-2 hours b) 48 hours c) 5 days d) 2 weeks |
c) 5 days
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After sclerotherapy, the patient wore her elastic bandages for 5 days. Now how long does she have to wear standard elastic stocking?
a) 1 week b) 5 weeks c) 10 weeks d) indefinitely |
b) 5 weeks
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After a patient has undergone a ligation and stripping procedure for varicose veins, what is their recommended activity?
a) bed rest with elevated legs b) bed rest with heat packs c) frequent ambulation d) BRP only |
c) frequent ambulation
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A patient just underwent ligation/stripping for varicose veins. How often should they walk?
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every hour for 5-10 minutes while awake
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A patient who underwent sclerotherapy should expect a burning sensation for how long?
a) 1-2 hours b) 1-2 days c) 1-2 weeks d) 1-2 months |
b) 1-2 days
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The characteristic red streaks that extend up the arm or leg from the infected wound is characteristic of ____.
a) lymphangitis b) elephantiasis c) Cellulitis d) impetigo |
a) lymphangitis
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How can the patient be positioned to facilitate drainage and mobilization of collected fluids in the legs?
a) bed rest with elevated legs b) walking with compression stockings c) bedrest with legs lowered 15 degrees d) walking with no compression stockings |
a) bed rest with elevated legs
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What medication is given initially to treat fluid overload associated with lymphedema?
a) 2% sodium chloride b) spironolactone c) lasix d) fluid restriction |
c) lasix
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If Cellulitis is found, what type of medication is most likely to be prescribed?
a) steroids b) diuretics c) antibiotics d) anticoagulants |
c) antibiotics
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A patient receives a skin graft. What possible expectation should you warn them of?
a) loss of sensation in grafted area b) a lot of drainage c) inflammation around the wound margin d) slight tissue necrosis |
a) loss of sensation in grafted skin
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A patient comes to the emergency room with a leg with acute swelling, localized redness, and pain. They have a fever, chills, and sweating. What do they probably have?
a) lymphangitis b) lymphadenitis b) elephantiasis d) Cellulitis |
d) Cellulitis
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What are the most commonly over looked ares of Cellulitis?
a) palms and soles of feed b) back and buttocks c) neck and shoulder d) between the toes |
d) between the toes
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What blood pressures qualify as stage I hypertension?
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140/90 to 159/99
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What blood pressures qualify as stage II hypertension?
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greater than 160/100
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What is difference between primary and secondary hypertension?
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primary hypertension- the cause in unknown
secondary hypertension- the cause in known(structural/disease) |
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Why is hypertension called the silent killer?
a) it kills you in your sleep b) it sneaks up on you and you die very soon after diagnosis c) you usually suffocate to death d) you have no symptoms |
d) you have no symptoms- people with hypertension usually are symptom free
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What are some risk factors to hypertension?
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smoking, diabetes, obesity, age, genetics, inactivity
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What chamber of the heart is most likely to enlarge from hypertension?
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LV
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Kidney damage due to hypertension may initially present as:
a) frequent urination of 50 mL or less b) nocturia c) dyspnea d) bright yellow urine |
b) nocturia
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What is the first form of treatment in all types of hypertension?
a) lasix b) lifestyle modifications c) geographical relocation d) ACE inhibitors |
b) lifestyle modification
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What diuretic is stage I hypertension usually treated with?
a) loop diuretics b) potassium sparing diuretics c) thiazide diuretics d) alpha-1 diuretics |
c) thiazide diuretics
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If an aldosterone receptor blocker is administered with an ace inhibitor or ARB, what electrolyte imbalance should you monitor for?
a) hyponatremia b) hyponatremia c) hypokalemia d) hyperkalemia |
d) hyperkalemia
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Severe depression is an adverse side effect of what hypertension medication?
a) chlorhalidone (Hygroton) b) triamterene (Dyrenium) c) clonidine (Catapres) d) reserpine (Serpasil) |
d) reserpine (Serpasil)
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What is the drug of choice for pregnant women with hypertension?
a) methyldopa (Aldomet) b) triamterene (Dyrenium) c) clonidine (Catapres) d) reserpine (Serpasil) |
a) methyldopa (Aldomet)
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What do angiotension II receptor blockers (ARBs) end in?
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sartan!
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When preparing to take someones blood pressure, which of the following should you advise/ensure before taking the BP: Check all that apply:
a) avoid smoking cigarettes or drinking caffeine for 30 minutes before b) sit quietly for 5 minutes c) sit comfortably with the forearm supported at heart level on a firm surface with both feet on the ground d) avoid talking while measurement is being taken |
All of them!
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The blood pressure cuff should have a bladder width at least ___% of the person's arm circumference and a length of ___% of the arm circumference.
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40% for width
80% for length |
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If I choose a BP cuff that is too small for a patient, how will the results be altered?
a) they will be higher b) they will be lower c) they will be the same but it will hurt the patient |
a) they will be higher
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If I choose a BP cuff that is too big for a patient, how will the results be altered?
a) they will be higher b) they will be lower c) they will be the same but it will hurt the patient |
b) they will be lower
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How long does it take for the taste buds to adapt to a lower sodium diet?
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2-3 weeks
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Can beta blockers cause sexual dysfunction?
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Yes ladies!!! So keep your men in shape!!!
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A patient comes into the ER. He is diagnosed with hypertensive emergency. What was his blood pressure?
a) 160/100 b) 150/120 c) 180/120 d) 150/100 |
c) at least 180/120!!!
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What is the therapeutic goal of a patient's blood pressure in hypertensive emergency after 1 hour of therapy if his initial BP was 180/120?
a) 160/100 b) 140/90 c) 120/80 d) 110/70 |
a) 160/100: a goal of 25% reduction of the mean BP
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What is the goal systolic BP of a patient with a dissecting aorta?
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less than 100 if the patient can tolerate it
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How often do you take the BP in a patient whose BP is changing rapidly in hypertensive crisis? What if they are more stable?
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every 5 minutes if unstable
every 15-30 minutes if stable |
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What is a normal pediatric heart rate?
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120-160
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True or False: Children with heart failure are put on restricted fluids to protect the heart from an increased work load.
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False: They not usually put on restricted fluids due to the high risk for dehydration.
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A nurse is preparing to administer Digoxin to a child. Which of the following parameters would cause her to hold the dose?
a) HR 155 b) BP 120/80 c) HR 95 d) respirations 55 |
c) HR 95: Hold dig dose if heart rate is less than 100
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What sign would you look for in a child with CHF?
a) dependent edema in the feet b) edema in the eye lids and fingers c) edema in the knees and other joint spaces d) edema in the ankles and feet |
b) edema in the eye lids and fingers
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Mom gives birth to a healthy 7 lb baby. She goes home with the baby 48 hours later. What findings might she want to report to the doctor that could indicate an undetected heart issue?
a) infant wakes every 1-2 hours during the night b) infant is going through 6-8 diapers each day c) infant is not eating well/fatigues easily d) infant is burping up breast milk after large feedings |
c) infant is not eating well/fatigues easily
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After how many days can you expect to be able to hear the fetal heart beat?
a) 3 b) 10 c) 14 d) 24 |
d) 24 days
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How is oxygen carried to the infant heart?
a) pulmonary vein b) pulmonary artery c) umbilical vein d) umbilical artery |
a) pulmonary vein
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What is the name for the canal that runs from the pulmonary artery to the aorta in fetal circulation?
a) ductus venosus b) ductus arteriosus c) foramen ovale d) inferior vena cava |
b) ductus arteriosus
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Why does fetal circulation not travel through the fetal lungs?
a) the blood is already oxygenated b) the route is blocked c) the pressure in the ductus arteriosus is higher d) the foramen ovale is closed |
a) the blood is already oxygenated
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By what means does the fetal liver get oxygen?
a) ductus venosus b) ductus arteriosus c) foramen ovale d) inferior vena cava |
a) ductus venosus
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Some blood entering the fetal heart passes from the right atrium to the left atrium through the ____.
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Foramen ovale
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How do oxygen levels in the fetus compare to those of a newborn?
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They are lower in the fetus but they also have higher RBC to help compensate.
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The doctor tells the pregnant woman that her fetus is receiving 80% of the newborn oxygen saturation. How should this be interpreted?
a) this is abnormally low b) this is abnormally high c) this is right on target d) none of the above |
c) this is right on target
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What causes the ductus arteriosus to close?
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The infant takes its first breath, causing increased pressure in the LA and high oxygen level which closes the ductus arteriosus.
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What causes the foramen ovale to close?
a) increased pressure in the RA b) increased pressure in the RV c) increased pressure in the LA d) increased pressure in the LV |
c) increased pressure in the LA
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ASD is failure of the ___ to close.
a) ductus arteriosus b) ductus venosus c) foramen ovale |
c) foramen ovale
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When can you expect permanent closure of the foramen ovale?
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6 months
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What lab abnormality might you expect in a newborn with a CHD?
a) low RBC b) low WBC c) high ESR d) low ESR |
c) high ESR
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You are doing preoperative teaching for child scheduled for a cardiac cath. What do you tell the parents about the post-catheterization activity restrictions?
a) immediate ambulation with appropriate analgesics b) bed rest with leg straight for 6 hours c) bed rest for 12-24 hours after the cath d) no activity restriction, just as tolerated for the first 24 hours |
b) bed rest with leg straight for 6 hours
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Are ASD, VSD and PDA acyanotic or cyanotic?
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acyanotic
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What might symptoms of ASD, VSD, and PDA consist of? Check all that apply:
a) hepatomegaly b) dyspnea c) murmur d) decreased intracranial pressure |
a) hepatomegaly
b) dyspnea c) murmur *any sign of fluid volume overload including: tachypnea, and retractions |
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A cyanotic disorder involving decreased pulmonary flow is:
a) ASD b) tetralogy of Fallot c) VSD d) PDA |
b) tetralogy of Fallot
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Trace the normal blood flow through the newborn heart.
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IVC/SVC-RA-Tricuspid-RV-pulmonic valve-pulmonary artery-lungs-pulmonary vein-LA-bicuspid-LV-aortic value-aorta-Arteries
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What does ASD stand for? What is it?
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ASD stands for atrial septal defect- failure of the foramen ovale to close
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In ASD which chamber is enlarged and what is the direction of the shunting?
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RA is enlarged, and there is L to R shunting of blood
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What special heart sound can be heard in an infant with ASD?
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fixed split second heart sound
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In children, renal failure is considered when the output is less than ___ per hour along with an elevation in serum Creatinine and blood urea nitrogen.
a) 1 mL/kg b) 5 mL/kg c) 2 mL/kg d) 30 mL/kg |
a) 1 mL/kg
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What does VSD stand for and what does it mean?
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VSD- ventricular septal defect- there is a hole(s) in the ventricular septum
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In VSD what chamber is enlarged and what is the direction of the shunting?
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RV enlargement with left to right shunting
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What might you hear with VSD?
a) soft murmur b) harsh murmur/thrill c) thrill and mitral click d) fixed split |
b) harsh murmur/thrill
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What is PDA stand for and what is it?
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PDA- patent ductus arteriosus- its when the ductus arteriosus fails to close after birth
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A child with PDA is at higher risk for ___.
a) infrequent colds b) low ESR c) RSV d) Varicella |
c) RSV: and frequent colds
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What medication can be given to force the ductus arteriosus to close in a patient with PDA?
a) erythromycin b) glucocorticoid c) Indocin d) Pancrolipse |
c) Indocin
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Pulmonic stenosis or Pulmonic valve stenosis causes an increase in pressure in which chamber?
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right ventricle
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Aortic stenosis causes an increase in pressure in which chamber?
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left ventricle
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What does CoA stand for and what is it?
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CoA: Coarctation of the aorta, it is a narrowing of the descending aorta close to the carotid arteries
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What symptoms might a child with CoA display?
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pain/cyanosis of the legs
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Transposition of the great arteries is characterized by a swapped position of what 2 structures?
a) ventricles and atria b) superior and inferior vena cava c) pulmonary arteries and pulmonary veins d) aorta and pulmonary artery |
d) aorta and pulmonary artery
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In TGA, the aorta rises from the ___ side of the heart and the pulmonary artery arises from the ___ side of the heart.
a) left / right b) right / left c) left / left d) right / right |
b) right / left: the aorta rises from the right side of the heart and the pulmonary artery from the left
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What might symptoms of TGA be in a child?
a) hyperactivity b) cyanosis c) low RBC count d) bright red gums |
b) cyanosis
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What is tetralogy of Fallot characterized by?
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1. VSD
2. over-riding aorta 3. hypertrophic RV 4. pulmonary stenosis |
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What is the hallmark sign of TOF?
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cyanosis with crying or playing
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How is cyanosis with crying or playing in TOF relieved?
a) taking deep breaths b) applying oxygen c) squatting d) doing pull ups |
c) squatting
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A nurse can remember that all defects starting with a ___ are cyanotic.
a) p b) c c) h d) t |
d) t
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What might a patient presenting with these signs/symptoms have: vague symptoms such as a low-grade fever, malaise, loss of appetite, muscle aches, chills , sweating , stiff joints, back pain.
a) TOF b) ASD c) VSD d) SBE |
d) SBE-Subacute bacterial endocarditis
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What might a patient presenting with the following symptoms have: skin rash, cervical lymphadenopathy, edema and erythema of hands and feet, irritation and inflammation of the mouth with strawberry tongue, conjunctivitis.
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Kawasaki disease
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How is bacterial endocarditis treated?
a) it is self-resolving b) corticosteroids c) antibiotics d) no treatment since it is viral in nature |
c) antibiotics
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What is a complication of Kawasaki disease?
a) aneurysm b) lymphoma c) CHF d) varicose veins |
a) aneurysm
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What medications are used initially with treatment of Kawasaki disease?
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immunoglobulin and aspirin
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Patients with an engorged or aneurysmal vessels will most likely be on what type of medication?
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Anticoagulant to prevent thrombus formation
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Often individuals who have had rheumatic fever as children require a ____ at some time in their life.
a) heart transplant b) fem-pop c) PCTA d) valve replacement |
d) valve replacement-the heart may suffer due to deposits of the offending organism that grow on the valves of the heart causing permanent damage
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The nurse understands that when a valve is replaced in infancy or childhood, it must be replaced every ___ years to accommodate the child's growth.
a) 1 b) 5 c) 10 d) 15 |
b) 5
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Valves replaced during adolescence can last up to ___ years.
a) 1 b) 5 c) 10 d) 12 |
c) 10 years
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What is the most critical lab value to monitor in the postoperative pediatric patient who underwent open heart surgery?
a) sodium b) potassium c) chlorine d) magnesium e) BUN |
b) potassium- because the cardiac bypass machine hemolyzes the cells, thus creating a high concentration of extracellular potassium
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When the heart condition coarctation of the aorta is suspected, the pediatric nurse will include which of the following in the nursing assessment(Check all that apply):
a) take the child's BP in all 4 extremities b) have the child lie down while taking the blood pressure c) encourage the child to play with a toy during the blood pressure d) encourage the pediatrician to order acetaminophen to sedate the child |
A,B,C
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When the blood pressure in the lower extremities is >10 mm Hg less than that in the upper extremities, what is suspected?
a) ASD b) VSD c) aortic stenosis d) CoA |
d) CoA
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The pediatric nurse recognizes that a possible long-term condition associated with Kawasaki disease is:
a) cervical lymphadenopathy b) aneurysm formation c) SOB d) mitral valve damage |
b) aneurysm formation
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The cardiac condition tetralogy of Fallot includes which of the following defects? Check all that apply:
a) pulmonary stenosis or atresia b) ventricular septal defect c) overriding aorta d) hypertrophic right ventricle |
A,B,C,D
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A 14-year-old child with a history of rheumatic fever is being discharged home after a heart valve replacement. What information would be important for the pediatric nurse to communicate to the family during discharge teaching?
a) "the heart valve will last the child's entire life" b) "the child will be on thrombolytic agents for life c) "the child may be at risk for frequent fainting episodes" d) "approximately every 10 years the heart valve may need to be replaced |
d) "approximately every 10 years the heart valve and need to be replaced"
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What is the primary nursing intervention for the child who has undergone a cardiac cath?
a) administer morphine sulfate for pain b) compare pre-intervention saturation levels with post intervention saturation levels c) ensure the HOB is elevated to a 30 degree angle d) remove the pressure dressing 1-2 hours post-cardiac cath |
b) compare pre-intervention saturation levels with post saturation levels
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In atrial septal defect there is left to right shunting of blood with hypertrophy of the ___ chamber.
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right atrium
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Where is the murmur auscultated with ASD?
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left sternal border
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What is the primary treatment in atrial septal defect?
a) immediate surgery b) cardiac cath c) watchful waiting d) Indocin |
c) watchful waiting
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What is a possible complication of untreated VSD?
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right ventricular CHF
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True of False: Newborn heart murmurs can be a normal finding due to the not fully patent ductus arteriosus.
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True!
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What defect is characterized by a loud machinery murmur and wide pulse pressure?
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PDA
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What chamber of the heart may become enlarged due to pulmonic stenosis?
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RV
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What chamber of the heart may become enlarged due to aortic stenosis?
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LV
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Unrepaired pulmonic or aortic stenosis can lead to ___ ___ ___.
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CHF
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Kawasaki is characterized by ___ of the endothelium of the vessels.
a) inflammation b) shortening c) occluding d) disintegration |
a) inflammation- may lead to MI, aneurysm, clots, obstruction
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Which medication would you NOT give to a patient with Kawasaki disease?
a) ibuprofen b) aspirin c) abciximab d) immune globulin e) steroids |
e) steroids
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Why are steroids contraindicated in patients with Kawasaki disease?
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they may cause residual stenosis of the coronary artery
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What disorder is characterized by an immune response that causes inflammation and fibrin deposits on the endocardium and valves and joints?
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rheumatic fever
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What initial activity level would be recommended with a patient diagnosed with rheumatic fever?
a) amb frequently b) BRP c) bed rest d) activity as tolerated |
c) bed rest to minimize inflammation
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What effect on an EKG might rheumatic fever cause?
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prolonged P-R and QT intervals
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Pharmaceutical management of the patient with rheumatic fever include: check all that apply:
a) penicillin b) NSAIDS c) atropine d) corticosteroids e) phenobarbital and diazepam f) Digoxin/diuretics |
a, b, d, e, f
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Why would Digoxin, diuretics, phenobarbital and diazepam be prescribed for a person with rheumatic fever?
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Because rheumatic fever causes heart valve defects, so by decreasing the work load on the heart, the valve will function better.
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