Pediatrics - Alterations In Cardiovascular Function Part I

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  • 1/22 Questions

    Usually with this type of lesion, one would see an increase in pulmonary blood flow with left to right shunting. This manifests during infancy or early childhood.

    • Cyanotic Lesion
    • Acyanotic Lesion
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Pediatrics - Alterations In Cardiovascular Function Part I - Quiz
About This Quiz

This Pediatrics quiz focuses on alterations in cardiovascular function, particularly in congenital heart diseases. It assesses understanding of acyanotic and cyanotic lesions, symptoms of congestive heart disease, and necessary interventions, crucial for pediatric healthcare professionals.

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  • 2. 

    Cyanotic lesions have right to left shunting & __________ pulmonary blood flow.

    • Increased

    • Decreased

    • Maintain

    Correct Answer
    A. Decreased
    Explanation
    Cyanotic lesions are characterized by a right to left shunting of blood, meaning that deoxygenated blood bypasses the lungs and enters the systemic circulation. This leads to a decrease in pulmonary blood flow, as less blood is being oxygenated in the lungs. Therefore, the correct answer is "Decreased."

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  • 3. 

    A child with a cyanotic lesion needs surgical intervention.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    A cyanotic lesion refers to a condition where there is a lack of oxygen in the blood, resulting in a bluish discoloration of the skin and mucous membranes. This indicates a serious underlying problem with the child's cardiovascular system. Surgical intervention is often necessary to correct the issue and improve blood flow and oxygenation. Therefore, the statement that a child with a cyanotic lesion needs surgical intervention is true.

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  • 4. 

    Which of the following is expected when auscultating the child with Congestive Heart Disease? (Select All That Apply)

    • Murmurs

    • Diminished Breath Sounds

    • Fluid in Lungs

    • Tachypnea

    Correct Answer(s)
    A. Murmurs
    A. Fluid in Lungs
    A. Tachypnea
    Explanation
    When auscultating a child with Congestive Heart Disease, it is expected to hear murmurs. This is because murmurs are abnormal sounds that are caused by turbulent blood flow through the heart. Additionally, fluid in the lungs is expected in Congestive Heart Disease as the heart's inability to pump blood effectively can lead to fluid accumulation in the lungs. Tachypnea, or rapid breathing, is also expected as the body tries to compensate for the decreased oxygenation caused by the heart's inefficiency. Diminished breath sounds, however, are not typically associated with Congestive Heart Disease and would not be expected.

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  • 5. 

    Upon inspection of a child with congestive heart disease, you note cyanosis, pallor, squatting, edema in the face & fatigue. Classic symptoms of congestive heart disease. What problems would you expect to see with the client's weight due to the disease?

    • Poor Weight Gain

    • Excessive Weight Gain

    • No problems with weight

    Correct Answer
    A. Poor Weight Gain
    Explanation
    In congestive heart disease, the heart is unable to pump blood effectively, leading to poor circulation and inadequate oxygenation of tissues. This can result in decreased appetite and difficulty in feeding, causing poor weight gain in the child. Additionally, the increased workload on the heart can lead to increased energy expenditure, further contributing to poor weight gain. Therefore, it is expected that the child with congestive heart disease will have poor weight gain.

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  • 6. 

    Along with peripheral edema, what would you expect to note in the child with congestive heart disease?

    • Bounding Pulses

    • Diminished Pulses

    • Pulse Within Normal Limits

    Correct Answer
    A. Diminished Pulses
    Explanation
    In congestive heart disease, the heart is unable to pump blood effectively, leading to a decrease in blood flow throughout the body. This can result in diminished pulses, as the weakened heart is unable to generate a strong pulse. Therefore, it is expected to note diminished pulses in a child with congestive heart disease, along with peripheral edema.

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  • 7. 

    What clinical manifestations are seen with Increased Pulmonary Blood Flow? (Select all that apply)

    • Tachypnea

    • Cyanosis

    • Polycythemia

    • Frequent Respiratory Infections

    • Diaphoresis

    Correct Answer(s)
    A. Tachypnea
    A. Frequent Respiratory Infections
    A. Diaphoresis
    Explanation
    Increased pulmonary blood flow refers to a condition where there is an abnormal increase in the volume of blood flowing through the pulmonary circulation. This can occur due to congenital heart defects or conditions such as left-to-right shunts. Tachypnea, or rapid breathing, is seen as the body tries to compensate for the increased blood flow. Frequent respiratory infections may occur due to the increased workload on the lungs. Diaphoresis, or excessive sweating, can also be a manifestation of increased pulmonary blood flow. Cyanosis, a bluish discoloration of the skin, and polycythemia, an increased number of red blood cells, are not typically seen with increased pulmonary blood flow.

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  • 8. 

    What clinical manifestations are seen with obstructed systemic blood flow? (Select all that apply)

    • Diminished Pulses

    • Ventricular Septal Defect

    • Delayed Capillary Refill

    • Increased Urine Output

    • Coarctation of the Aorta

    Correct Answer(s)
    A. Diminished Pulses
    A. Delayed Capillary Refill
    A. Coarctation of the Aorta
    Explanation
    Obstructed systemic blood flow can lead to decreased blood supply to the peripheral tissues. This can result in diminished pulses, as the blood flow to the extremities is reduced. Delayed capillary refill is also seen, as the blood takes longer to reach the capillaries and refill them. Coarctation of the aorta is a congenital heart defect that can cause obstruction to blood flow, leading to these manifestations. Ventricular septal defect, on the other hand, is a communication between the ventricles and does not directly cause obstructed systemic blood flow. Increased urine output is not typically seen with obstructed systemic blood flow, as decreased blood supply to the kidneys would lead to decreased urine production.

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  • 9. 

    If a client shows signs of mixed defects, such as cyanosis, poor weight gain, pulmonary congestion, and CHF, what cardiac defect would you expect?

    • ASD

    • VSD

    • TOF

    • TGA

    Correct Answer
    A. TGA
    Explanation
    If a client shows signs of mixed defects such as cyanosis, poor weight gain, pulmonary congestion, and CHF, the cardiac defect that would be expected is Transposition of the Great Arteries (TGA). TGA is a congenital heart defect where the two main arteries, the pulmonary artery and the aorta, are switched in position. This results in deoxygenated blood being pumped back to the body and oxygenated blood being circulated back to the lungs, leading to cyanosis and poor oxygenation of the body. The symptoms of poor weight gain, pulmonary congestion, and CHF are also commonly associated with TGA.

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  • 10. 

    A client with a suspected heart defect is due for a cardiac catheterization with angiocardiogram at 11am. Which of the following statements would require further investigation & may delay or cancel the procedure?

    • I always eat a snack at 11pm before I go to sleep.

    • I love seafood - shrimp mainly. However, I've had an awful allergic reaction to shellfish before.

    • I took all of my maintenance medications last night, including my blood pressure medication.

    Correct Answer
    A. I love seafood - shrimp mainly. However, I've had an awful allergic reaction to shellfish before.
    Explanation
    The statement "I love seafood - shrimp mainly. However, I've had an awful allergic reaction to shellfish before" would require further investigation and may delay or cancel the procedure because the client has a known allergy to shellfish. Since the cardiac catheterization procedure involves the use of contrast dye, which can contain shellfish proteins, there is a risk of an allergic reaction during the procedure. Further investigation is needed to assess the severity of the allergy and determine if any precautions or alternative options are necessary to ensure the safety of the client during the procedure.

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  • 11. 

    Following a cardiac catheterization with angiocardiogram procedure, the nurse should apply direct pressure to the catheterization site for ___ min and then apply pressure dressing for ___ hours.

    • 10 Minutes, 2 Hours

    • 15 Minutes, 6 Hours

    • 30 Minutes, 12 Hours

    • 45 Minutes, 24 Hours

    Correct Answer
    A. 15 Minutes, 6 Hours
    Explanation
    Following a cardiac catheterization with angiocardiogram procedure, it is important for the nurse to apply direct pressure to the catheterization site for 15 minutes. This is necessary to ensure that any bleeding from the site is controlled and to prevent the formation of hematoma. After the direct pressure is applied, a pressure dressing should be applied for 6 hours. This helps to maintain pressure on the site and further prevent bleeding or hematoma formation.

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  • 12. 

    Clinical Manifestations of ______ sided heart failure: Decreased amount of blood being oxygenated by the lungs.

    • Right

    • Left

    Correct Answer
    A. Right
    Explanation
    Right-sided heart failure refers to the inability of the right side of the heart to effectively pump blood to the lungs for oxygenation. This can lead to a decreased amount of blood being oxygenated by the lungs. Symptoms of right-sided heart failure may include fluid retention, swelling in the legs and abdomen, and fatigue. Left-sided heart failure, on the other hand, refers to the inability of the left side of the heart to effectively pump blood to the rest of the body. Its clinical manifestations are different from those of right-sided heart failure.

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  • 13. 

    Clinical Manifestations of _____ sided heart failure: Lungs become congested with blood causing increase in pulmonary pressure & pulmonary edema

    • Right

    • Left

    • Neither

    Correct Answer
    A. Left
    Explanation
    Left-sided heart failure occurs when the left side of the heart is unable to efficiently pump blood to the rest of the body. This leads to a buildup of blood in the lungs, causing increased pulmonary pressure and pulmonary edema. The congested lungs result in symptoms such as shortness of breath, coughing, wheezing, and fluid retention. In contrast, right-sided heart failure primarily affects the right side of the heart and causes fluid buildup in the body's tissues, leading to symptoms such as swelling in the legs and abdomen. Therefore, the correct answer is left-sided heart failure.

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  • 14. 

    Which side of the heart usually fails in children & young infants?

    • Right Side

    • Left Side

    • Both Right & Left Sides Simultaneously

    Correct Answer
    A. Both Right & Left Sides Simultaneously
    Explanation
    In children and young infants, both the right and left sides of the heart can fail simultaneously. This is because the heart is still developing and may not be able to function properly. When both sides of the heart fail, it can lead to serious health complications and may require medical intervention.

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  • 15. 

    Which of the following CHF signs would more than likely NOT be seen in an infant or young child?

    • Nasal Flaring

    • Hepatomeagaly

    • Cardiomeagaly

    • Jugular Vein Distention

    Correct Answer
    A. Jugular Vein Distention
    Explanation
    Jugular vein distension-older children

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  • 16. 

    In addition to oxygen therapy & rest, which of the following medications is included in the plan of treatment for a CHF client that increases contractility of the heart?

    • Aldactone (Spironolactone)

    • Lanoxin (Digoxin)

    • Lasix (Furosemide)

    • Diuril (Chlorothiazide)

    Correct Answer
    A. Lanoxin (Digoxin)
    Explanation
    Digoxin, also known as Lanoxin, is included in the plan of treatment for a CHF (Congestive Heart Failure) client because it increases contractility of the heart. Digoxin works by inhibiting the sodium-potassium ATPase pump, which leads to an increase in intracellular calcium levels. This increase in calcium enhances the contractility of the heart muscle, improving cardiac output and reducing symptoms of CHF. Therefore, Digoxin is a commonly used medication in the treatment of CHF to help improve the heart's pumping ability.

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  • 17. 

    While ______ is the diuretic of choice for acute, severe CHF - we know that it excretes sodium, chloride, and water. While this medication also depletes potassium, signs & symptoms of digoxin toxicity should be monitored.

    • Aldactone (Spironolactone)

    • Inspra (Eplerenone)

    • Lasix (Furosemide)

    • Dyrenium (Triamterene)

    Correct Answer
    A. Lasix (Furosemide)
    Explanation
    Furosemide, also known as Lasix, is the diuretic of choice for acute, severe congestive heart failure (CHF). It helps to remove excess fluid from the body by excreting sodium, chloride, and water. However, it can also deplete potassium levels in the body. Therefore, when administering Furosemide, healthcare professionals should monitor for signs and symptoms of digoxin toxicity, which can occur due to low potassium levels.

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  • 18. 

    Digoxin, the drug of choice to treat CHF causes increased force of contraction, decreased heart rate, and increased renal perfusion should not be used in children younger than what age?

    • One Month

    • Six Months

    • Twelve Months

    • 18 Months

    Correct Answer
    A. One Month
    Explanation
    Digoxin, a medication used to treat congestive heart failure (CHF), can cause increased force of contraction, decreased heart rate, and increased renal perfusion. However, it is not recommended for use in children younger than one month old. This is likely due to the fact that infants in this age range may have immature organ systems, including the heart and kidneys, which could potentially be more susceptible to the effects of the medication. Therefore, it is important to avoid using digoxin in children younger than one month to prevent any potential harm.

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  • 19. 

    Which of the following clients with CHF should the order for Digoxin be withheld?

    • 2 Year Old HR 105

    • 7 Year Old HR 75

    • 13 Year Old HR 65

    • None of the above

    Correct Answer
    A. 7 Year Old HR 75
    Explanation
    Check apical pulse for one full minute
    - hold if HR < 100 (infant/toddler)
    - hold if HR < 80 (older child)
    - hold if HR < 60 (adolescent)

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  • 20. 

    Which of the following statements is false regarding the "Rules of Digoxin?"

    • Give every 12 Hours

    • If missed dose is more than 2 hours late, then do not give that dose

    • Give 20 to 30 minutes before or 2 hours after meals

    • If client vomits after taking Digoxin, do not repeat dose

    Correct Answer
    A. If missed dose is more than 2 hours late, then do not give that dose
    Explanation
    If missed dose is more than 4 hours late then do not give that dose

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  • 21. 

    The CHF client should maintain a potassium enriched diet. Which of the following are NOT enriched with Potassium?

    • Oranges & Bananas

    • Legumes & Potatoes

    • Apricots, Peaches, Prunes & Dates

    • Cranberries & Blueberries

    Correct Answer
    A. Cranberries & Blueberries
    Explanation
    Oranges and orange juice
    Bananas
    Legumes
    Raisins, prunes, dates
    Potatoes
    Apricots, peaches
    Tomato juice

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  • 22. 

    Which of the following is false in caring for the pediatric client with CHF?

    • Position Semi-Fowlers (45 degrees)

    • Report weight gain > 20g/day

    • Burp every 1 to 2 ounces

    • Limit feedings 20 to 30 Minutes depending on the client

    Correct Answer
    A. Report weight gain > 20g/day
    Explanation
    Position semi-fowler's (45 degrees)
    Small, frequent feedings
    Burp every 1 - 2 ounces
    Limit feedings to 20-30 minutes
    Alternate oral and tube feedings
    Weigh daily
    report gain > 50 g/day

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Quiz Review Timeline (Updated): Mar 19, 2023 +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 19, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Sep 16, 2012
    Quiz Created by
    Hsams7579
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