A nurse is caring for an infant who has a congenital heart defect. Which of the following defects is associated with increased pulmonary blood flow?
Tricuspid atresia
Patent ductus arteriosus
Coarctation of the aorta
Tetralogy of Fallot
The Correct Answer is B
A. Tricuspid atresia typically leads to decreased pulmonary blood flow due to the absence of normal blood flow to the lungs.
B. Patent ductus arteriosus results in increased pulmonary blood flow because it allows blood to flow from the aorta to the pulmonary artery, increasing the volume of blood going to the lungs.
C. Coarctation of the aorta can cause decreased blood flow to the lower body, which may not directly relate to increased pulmonary blood flow.
D. Tetralogy of Fallot is characterized by decreased pulmonary blood flow due to right ventricular outflow obstruction, making it not associated with increased pulmonary blood flow.
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Correct Answer is C
Explanation
A. Clients on digoxin should actually have an adequate intake of potassium, as low potassium levels can increase the risk of digoxin toxicity.
B. If a pediatric client spits out digoxin, the dose should not be repeated automatically; instead, the nurse should assess the situation and follow the facility's protocol regarding missed doses.
C. Measuring the apical pulse for one full minute before administering digoxin is critical; if the pulse is below the established threshold (usually <60 bpm for children), the medication should be held and the provider notified.
D. While evaluating for nausea, vomiting, and anorexia is important, it is not an appropriate immediate action before administering the medication. The priority action is to assess the apical pulse.
Correct Answer is D
Explanation
A. Improved hydration is important but not directly indicative of an asthma attack improvement.
B. A barking cough is often associated with conditions like croup and does not indicate improvement in asthma symptoms.
C. Decreased temperature is not a specific indicator of improvement in asthma and may not correlate with the severity of an asthma attack.
D. Decreased stridor indicates a reduction in airway obstruction and inflammation, signifying an improvement in the child’s respiratory status during an asthma attack.