A nurse is assessing a newborn for manifestations of a large patent ductus arteriosus. Which of the following findings should the nurse expect?
Weak pulses
Cyanosis with crying
Chronic hypoxemia
Systolic murmur
The Correct Answer is D
A. Weak pulses are more indicative of reduced cardiac output or other cardiac issues, rather than specifically a large patent ductus arteriosus (PDA).
B. Cyanosis with crying can occur in various conditions, but it is not a hallmark of a large PDA; it typically presents with other symptoms.
C. Chronic hypoxemia is more associated with severe heart defects or lung conditions, whereas a large PDA may present with other signs first.
D. A systolic murmur is a classic finding in large PDAs due to the left-to-right shunting of blood, making it the most expected manifestation in this scenario.
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Correct Answer is C
Explanation
A. Feeding on a strict schedule may not be beneficial for an infant with heart failure, as these babies often require more frequent, smaller feedings to prevent fatigue and ensure adequate nutrition.
B. Allowing the baby to take as much time as needed can be beneficial, but it is crucial to monitor for fatigue and ensure the infant receives sufficient nutrition within a reasonable time frame.
C. Adding increased calorie supplements to each bottle is an effective strategy to help meet the increased caloric needs of an infant with heart failure, indicating an understanding of the nutritional requirements.
D. While minimizing crying can be helpful, the focus should be on the infant's needs and ensuring they are fed before they become overly distressed, rather than a strict limit on crying time.
Correct Answer is D
Explanation
A. Visualizing the epiglottis with a tongue depressor is contraindicated in suspected epiglottitis due to the risk of triggering airway obstruction.
B. Transporting the child to radiology for a throat x-ray is not a priority and can delay necessary interventions.
C. Obtaining a throat culture is not appropriate in this situation, as airway compromise can occur quickly, and immediate management is crucial.
D. Placing the child in an upright position helps ease breathing and can alleviate distress, which is vital for a child with suspected epiglottitis.