A nurse is assessing a newborn who has a coarctation of the aorta. Which of the following should the nurse recognize is a clinical manifestation of coarctation of the aorta?
Decreased blood pressure in the arms with increased blood pressure in the legs
Increased blood pressure in the arms with decreased blood pressure in the legs
Decreased blood pressure in both the arms and the legs
Increased blood pressure in both the arms and the legs
The Correct Answer is B
A. This option is incorrect as it does not describe the expected blood pressure difference in coarctation of the aorta.
B. Coarctation of the aorta typically presents with higher blood pressure in the upper body (arms) and lower blood pressure in the lower body (legs) due to the obstruction of blood flow distal to the aortic arch.
C. This option is incorrect because while coarctation can lead to decreased perfusion in the lower extremities, it does not typically result in decreased blood pressure in both the arms and legs simultaneously.
D. While increased blood pressure may occur in the arms, the legs would not typically show increased blood pressure in cases of coarctation.
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Correct Answer is C
Explanation
A. Bradycardia is not typically expected in toddlers with heart failure; instead, tachycardia (increased heart rate) is more common as the body compensates for decreased cardiac output.
B. Weight loss is generally not a typical finding in toddlers with heart failure; rather, they often experience weight gain due to fluid retention.
C. Orthopnea, or difficulty breathing when lying flat, is a common symptom of heart failure and would be expected in a toddler due to fluid overload affecting respiratory function.
D. Increased urine output is usually not expected in heart failure; rather, fluid retention often leads to decreased urine output as the kidneys respond to the body's fluid balance needs.
Correct Answer is B
Explanation
A. A stool fat content analysis can suggest malabsorption issues but does not specifically confirm cystic fibrosis.
B. The sweat chloride test measures the amount of chloride in the sweat, with elevated levels confirming a diagnosis of cystic fibrosis.
C. Pulmonary function tests assess lung function but are not definitive for diagnosing cystic fibrosis.
D. A sputum culture can identify respiratory infections but is not specific for cystic fibrosis diagnosis.