Cardio
How many chambers make up the heart?
4
How many types of skin traction are there and what are they. (no partial credit)
What is 3...Bryant's traction, Buck's extension, Russell traction
A hallmark of this acute systemic vasculitis is a strawberry tongue with white coating or red bumps in the posterior aspect.
What is kawasaki disease?
Which would the nurse expect to assess on a 3-week-old infant with developmental
dysplasia of the hip (DDH)?
1. Excessive hip abduction.
2. Femoral lengthening of an affected leg.
3. Asymmetry of gluteal and thigh folds.
4. Pain when lying prone.
3) in hip dysplasia, asymmetrical thigh and gluteal
folds are frequently present.
The infant with congestive heart failure (CHF) has a need for:
a. decreased fat.
b. increased fluids.
c. decreased protein.
d. increased calories.
ANS: D
Infants with CHF have a greater metabolic rate because of poor cardiac function and increased heart and respiratory rates. Their caloric needs are greater than those of average infants, yet their ability to take in calories is diminished by their fatigue. The diet should include increased protein and increased fat to facilitate the child's intake of sufficient calories. Fluids must be carefully monitored because of the CHF.
An 8 m/o with Tetralogy of Fallot becomes irritated, upset, and inconsolable. They start turning blue around the mouth and in the fingers and toes. What interventions do you perform?
Knees to chest
Try to calm baby
Supplemental oxygen
IV fluids
Differences between a strain and a sprain
What is Strain -microscopic tear to muscle or tendon. Sprain - ligament is torn or stretched away from bone at point of trauma
This inflammatory disease occurs as a reaction to Group A beta hemolytic streptococcus infection in the throat. Usually occurs 2 to 6 weeks following untreated or partially treated upper respiratory infection (strep throat). Diagnosis of this disease is made using the Jones Criteria
What is Rheumatic Fever?
The nurse is teaching about congenital clubfoot in infants. The nurse evaluates the
teaching as successful when the parent states that clubfoot is best treated when?
1. Immediately after diagnosis.
2. At age 4 to 6 months.
3. Prior to walking (age 9 to 12 months).
4. After walking is established (age 15 to 18 months).
1. The best outcomes for clubfoot are seen
if casting begins as soon as the diagnosis
is made.
The nurse should recognize that congestive heart failure (CHF) is which of the following?
a. Disease related to cardiac defects
b. Consequence of an underlying cardiac defect
c. Inherited disorder associated with a variety of defects
d. Result of diminished workload imposed on an abnormal myocardium
ANS: B
CHF is the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures to meet the body's metabolic demands. CHF is not a disease but rather a result of the inability of the heart to pump efficiently. CHF is not inherited. CHF occurs most frequently secondary to congenital heart defects in which structural abnormalities result in increased volume load or increased pressures on the ventricles.
A chest x-ray examination is ordered for a child with suspected cardiac problems. The child's parent asks the nurse, "What will the x-ray show about the heart?" The nurse's response should be based on knowledge that the x-ray film will do which of the following?
a. Show bones of chest but not the heart
b. Evaluate the vascular anatomy outside of the heart
c. Show a graphic measure of electrical activity of the heart
d. Provide information on heart size and pulmonary blood flow patterns
ANS: D
Chest x-ray films provide information on the size of the heart and pulmonary blood flow patterns. The bones of the chest are visible on the chest x-ray film, but the heart and blood vessels are also seen. Magnetic resonance imaging is a noninvasive technique that allows for evaluation of vascular anatomy outside of the heart. A graphic measure of electrical activity of the heart is provided by electrocardiography.
Treatment of soft tissue injuries
What is RICE rest, ice, compress and elevate
This pediatric congenital heart defect is characterized by a hole between the left and right ventricle (left to right shunting), loud hard murmur auscultated at the left sternal border and can result in heart in heart failure.
What is ventricular septal defect (VSD)
When is scoliosis typically diagnosed?
occurs in girls more often should be screened around 10-12 years of age and boys screened around 13-14 years of age
Think late elementary-middle school
John is a 6-year-old child scheduled for a cardiac catheterization. Preoperative teaching should be which of the following?
a. Directed at his parents because he is too young to understand
b. Adapted to his level of development so that he can understand
c. Done several days before the procedure so he will be prepared
d. Provide details about the actual procedures so he will know what to expect
ANS: B
Preoperative teaching should always be directed to the child's stage of development. The caregivers also benefit from these explanations. The parents may ask additional questions, which should be answered, but the child needs to receive the information based on developmental level. This age-group will not understand in-depth descriptions. School-age children should be prepared close to the time of the cardiac catheterization.
Treatment for & reason we treat Kawasaki Disease.
What is What is Aspirin & IV gamma globulin (IVIG) to prevent coronary artery aneurysm and death?
What type of traction does the child's body supply the countertraction?
What is Bryant's traction
This pediatric congenital heart defect includes four defects that result in mixed blood flow. Cyanosis is present at birth and is progressive over the first year of life. Presentation also includes a systolic murmur and episodes of acute cyanosis and hypoxia.
What is Tetralogy of Fallot (TOF)?
A 7-year-old boy is in the emergency department with a greenstick fracture of the ulna. How will the nurse explain the fracture to the parents?
1.The bone is broken across the growth plate.
2.There is a splintering of the bone on one side.
3.There is a separation of the bone at the fracture site.
4.The bone is broken into several fragments.
2. Greenstick fracture refers to splintering of the bone, not a complete fracture. The name comes from the splintering effect in attempts to break a "greenstick." It is a common fracture in children. A comminuted fracture (bone is broken into several fragments) has multiple bone fragments and is more common in adults. Greenstick fractures do not affect the growth plate and there is no bone separation.
The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is "too wet." The nurse finds the bandage and bed soaked with blood. The most appropriate initial nursing action is which of the following?
a. Notify the physician.
b. Place child in Trendelenburg position.
c. Apply a new bandage with more pressure.
d. Apply direct pressure above catheterization site.
ANS: D
When bleeding occurs, direct continuous pressure is applied 2.5 cm (1 inch) above the percutaneous skin site to localize pressure on the vessel puncture. The physician can be notified and a new bandage with more pressure can be applied after pressure is applied. The nurse can have someone else notify the physician while the pressure is being maintained. Trendelenburg position would not be a helpful intervention. It would increase the drainage from the lower extremities.
Why do holes in the heart (Atrial septal defect, ventricular septal defect, patent ductus arteriosus) lead to an increase in pulmonary blood flow?
L to R shunt. L-side of heart has increased muscle, pressure, and contraction to supply the rest of the body.
A 1 y/o suffers a traumatic injury and fractures their femur. As a nurse, what questioning attitude do you practice? It was found to be accidental, what do you educate the parents about when they say "my baby will never be able to walk now."
Bone healing in children happens quite rapidly. This pt, likely about 4-weeks.
The pediatric congenital heart defect is characterized as a condition in which the normal fetal circulation conduit between the pulmonary artery and the aorta fails to close and results in increased pulmonary blood flow (left to right shunt). If present, symptoms can include machine like murmur, wide pulse pressure, and bounding pulses. Nonsurgical treatment of this condition includes administration of indomethacin.
What is patent ductus arteriosus (PDA)?
A 10-year-old female arrives to the ER with a right leg fracture. An x-ray is performed and shows a closed tibia fracture. A closed reduction is performed and a cast is put in place. The patient is ordered Morphine 2 mg IV every 4-6 hours as needed for pain. The patient calls on the call light to tell you the pain medication is not working and that it even hurts to slightly stretch the leg. What is your response to this statement by the patient? Select all that apply:
A. Reassure the patient that this is normal after a bone fracture, and reposition the cast.
B. Re-adjust the cast to ensure it fits snugly against the fracture.
C. Perform neurovascular checks.
D. Elevate the leg above heart level.
E. Loosen and remove restrictive items.
F. Notify the physician.
C, E, F
It is not normal for pain to not be relived with medication and should be investigated/reported to the physician along with performing some nursing interventions. We definitely don’t want to readjust the cast because this will increase the muscle’s compartment pressure even more. We want to decrease pressure and re-adjusting the cast to fit more snugly will cause more problems.
Yes, we want to perform neurovascular checks. CORRECT! As discussed above in detail, we want to check the 6 P’s….pain (early sign), paresthesia, pallor, paralyisis, poikilothermia, pulselessness (late sign).
We want to keep the leg AT HEART LEVEL, not above it. Keep the extremity at heart level helps maintain arterial pressure, which is very important because the muscle compartment is experiencing ischemia.
We do want to loosen and remove restrictive items to help alleviate any extra pressure on the compartment!
We will absolutely be Notifying the physician. Of course, we will be doing this while simultaneously doing all the other things. The MD may order bivalvement of the cast (cutting it in half) or performing a fasciotomy in severe cases.
List the cardiac defects of right to left shunting of blood:
What is:
Tetralogy of Fallot
Truncus Arteriosus
Transposition of the Great Vessels
(3 T's of CYANOTIC defects)