An infant is brought to the emergency department with suspected coarctation of the aorta. Which clinical symptoms would the nurse expect to find?
Cyanosis of the lips and tongue
Weak or absent femoral pulses
Bounding pulses in the upper extremities
High blood pressure in the lower extremities
Poor feeding and irritability
Correct Answer : B,C,E
A. Cyanosis of the lips and tongue is not a typical finding in coarctation of the aorta; rather, it is more associated with cyanotic congenital heart defects.
B. Weak or absent femoral pulses are expected due to reduced blood flow to the lower body, as the coarctation typically occurs distal to the left subclavian artery.
C. Bounding pulses in the upper extremities are common because the blood flow to the upper body is increased, leading to stronger pulses.
D. High blood pressure in the lower extremities is not typical; instead, there is often lower blood pressure in the lower body due to the obstruction.
E. Poor feeding and irritability are common symptoms in infants with heart conditions, as they may be in distress or not getting enough blood flow to meet their metabolic needs.
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Correct Answer is C
Explanation
A. The meningococcal (MCV4) vaccine is typically recommended for preteens and adolescents, usually starting at age 11.
B. The hepatitis B vaccine is typically administered at birth, 1-2 months, and 6-18 months, so a 4-year-old may already have received this vaccine.
C. The varicella (VAR) vaccine is recommended for children at ages 12-15 months and again at 4-6 years, making it appropriate for a 4-year-old child.
D. The Haemophilus influenza type b (Hib) vaccine is usually given to children in a series before 5 years of age, but it is more commonly completed by age 2-3 years. The 4-year-old may already be up to date with this vaccine.
Correct Answer is ["A","B","D","E"]
Explanation
A. It is important for the client to remain in bed for a specified time (typically 4 to 6 hours) to prevent complications such as bleeding at the catheter insertion site.
B. Checking peripheral pulses in the affected extremity is crucial for assessing circulation and identifying any potential complications, such as hematoma or occlusion.
C. High-Fowler's position is not typically appropriate immediately after cardiac catheterization; the client should remain flat or with limited elevation to reduce stress on the insertion site.
D. Keeping the hip and leg extended is important to prevent flexion at the site of catheter insertion, reducing the risk of bleeding or hematoma formation.
E. Measuring vital signs is essential after a procedure like cardiac catheterization to monitor for any changes that may indicate complications; however, the frequency is typically more frequent than every 4 hours initially.