Congenital Heart Defects
An infant becomes cyanotic during feeding and crying. What underlying pathophysiology explains this?
Right-to-left shunting decreasing pulmonary blood flow
Why must digoxin be administered carefully in infants?
Narrow therapeutic range
What is the priority intervention during a vaso-occlusive crisis?
Hydration
A child has a “whooping” cough. What is the likely cause?
Bordetella pertussis
Which findings suggest pneumonia rather than dehydration?
Elevated WBC, cough, chest discomfort
A child with a left-to-right shunt is at highest risk for what long-term complication if untreated?
Pulmonary hypertension
A parent reports vomiting after digoxin administration. What is the nurse’s priority teaching?
Do NOT repeat the dose
Why does excessive cow’s milk intake increase anemia risk?
Low iron and replaces iron-rich foods
What is the priority intervention for bronchiolitis?
Airway suctioning
What is the first-line medication for acute asthma exacerbation?
Short-acting beta agonist
A nurse notes weak femoral pulses but strong upper extremity pulses. What condition is most likely?
Coarctation of the aorta
What is the most important teaching to prevent digoxin toxicity?
Monitor for vomiting, poor feeding, bradycardia
What is the underlying cause of symptoms in sickle cell disease?
RBC destruction + vessel occlusion
A child with asthma has decreased wheezing. Why is this concerning?
“silent chest” = severe obstruction
A child has decreased PEFR. What does this indicate?
Worsening asthma control
Why do infants with Tetralogy of Fallot have poor weight gain?
Fatigue leads to inadequate caloric intake
A child is in a hypercyanotic spell. What is the FIRST nursing action?
Place in knee-chest position
A child with hemophilia has joint bleeding. What is the priority intervention?
Administer factor VIII
What positioning helps reduce discomfort in pneumonia?
Lie on affected side
A child with drooling, fever, and tripod positioning requires what action?
Immediate airway management / notify provider
What assessment finding most strongly supports a ventricular septal defect?
Holosystolic murmur at left sternal border
Why do infants with heart failure require increased caloric intake?
Higher metabolic demand + fatigue limiting intake
Why is oxygen not the primary treatment for severe anemia?
Lack of hemoglobin limits oxygen delivery
What isolation precautions are required for RSV?
Contact + droplet precautions
A child with respiratory distress has retractions, nasal flaring, and tachypnea.
What is your FIRST priority?
Airway clearance (suctioning)