Category 1
Tetralogy of fallot is a very common condition caused by HTN. True or false ?
False
TOF is considered an acyanotic congenital heart defect.
True of false?
False. It is in fact a cyanotic heart defect
Use of hypertensives during pregnancy is the main know cause for TOF
True or False
False. There is no KNOWN cause for TOF
Beta blockers is a treatment for TOF.
True or false
True
Surgical repair
What position should you place a child in during a tet spell?
Knee-chest position
What is the priority nursing intervention during a cyanotic episode?
Administer oxygen and position child in knee-chest position.
What is a " Tet spell" ?
Baby usually presents with cyanosis during feeding or crying
what is the temporary repair for TOF?
Shunt or stent procedure
What is a possible cause of TOF?
changes to genes or chromosomes may result in TOF
Which of the following is a symptom of TOF?
1. rapid breathing
2. Hypotension
3. Xerostomia
4. screaming
1. rapid breathing
What position would you see a child with TOF in to compensate ?
1. lying on back
2. squatting
3. lying on stomach
4. Standing with head down and hands above head
2. squatting. This increases vascular resistance, which reduces the right-to-left shunt and improves oxygenation.
which of the following are clinical manifestations see in a child with TOF ?
1. Clubbing in nails
2. Angioedema
3.Hemifacial spasm
4. fatigue
1. clubbing in nails
Which of the following are risk factors of TOF?
1. Down syndrome
2. Guillain-Barré syndrome
3. Bell's palsy
4. Multiple Sclerosis
1. Down syndrome
Which of the following is NOT a defect associated with Tetralogy of Fallot?
A. Ventricular septal defect
B. Pulmonary stenosis
C. Patent ductus arteriosus
D. Right ventricular hypertrophy
C. Patent ductus arteriosus
In Hypertrophy defect, The right lower chamber of the heart is bigger or thicker than normal.
True or False
True
Which of the following describes Pulmonary stenosis?
1. A narrowed or stiffened pulmonary valve means the pulmonary artery has trouble sending enough blood from the heart to the lungs.
2.the artery that carries oxygen-rich blood to the body, is out of place
3.hole between the two lower chambers of the heart
4. The right lower chamber of the heart is thinner or than normal.
1. A narrowed or stiffened pulmonary valve means the pulmonary artery has trouble sending enough blood from the heart to the lungs.
Which of the following are clinical manifestations of TOF?
1. Nose bleed
2. Blepharitis
3.Macular stain
4. circumoral cyanosis
4. circumoral cyanosis
A newborn with Tetralogy of Fallot is most likely to present with which of the following symptoms?
A. Pink skin and normal oxygen saturation
B. Severe bradycardia and hypotension
C. Cyanosis and a harsh systolic murmur
D. Hypertension and bounding pulses
C. Cyanosis and a harsh systolic murmur
Which of the following is nursing intervention for Ineffective tissue perfusion r/t decreased oxygenated blood flow ?
1. Assess capillary refill time and skin color
2. Educate parent on changing formula for the baby
3. Place patient in high-fowlers position
4. Monitor RBC levels
1. Assess capillary refill time and skin color
You're providing an in-service to a group of new nurses who will be caring for patients who have Tetralogy of Fallot. Which statement below is INCORRECT concerning how the blood normally flows through the heart?*
1.Unoxygenated blood enters through the superior and inferior vena cava and travels to the left atrium.
2.The pulmonic valve receives blood from the right ventricle and allows blood to flow to the lungs via the pulmonary artery.
3. The left atrium allows blood to flow down through the bicuspid valve (mitral) into the left ventricle.
4.Oxygenated blood leaves the left ventricle and flows up through the aortic valve and aorta to be pumped to the rest of the body.
1.Unoxygenated blood enters through the superior and inferior vena cava and travels to the left atrium.
rationale: The answer is 1. This statement is INCORRECT. It should say: "Unoxygenated blood enters through the superior and inferior vena cava to the RIGHT (not left) atrium.
You're caring for a newborn who has Tetralogy of Fallot with severe cyanosis. You anticipate the newborn will be started on ___________?
1. Indomethacin
2. Diclofenac
3.. Celecoxib
4. Alprostadil
4. Alprostadil
ratioanle: Alprostadil, prostaglandin E, will keep the ductus arteriosus open after birth. This will help with keeping the oxygen levels up because it allows more blood to flow to the lungs that is oxygenated via the ductus arteriosus.
As the nurse you know which statements are TRUE about Tetralogy of Fallot? Select all that apply:
1,2, and 4
rationale: The answers are 1, 2,, and 4 because this condition can be treated with both palliative surgery and complete repair.
. While feeding a 3-month-old infant, who has Tetralogy of Fallot, you notice the infant's skin begins to have a bluish tint and the breathing rate has increased. Your immediate nursing action is to?
rationale: The patient is experiencing a "tet spell". This is where during any type of activity like feeding, crying, playing etc. the child's heart is unable to maintain proper oxygen levels in the blood. The nurse would want to place the infant in the knee-to-chest position to increase systemic vascular resistance
As the registered nurse you are developing a plan of care for a patient with Tetralogy of Fallot. Select all the appropriate nursing diagnoses below that would be specific to this patient:
1.Risk for deficient fluid volume
2.. Activity Intolerance
3. Failure to thrive
4.Risk for impaired liver function
3. Failure to thrive
rationale: the patient can experience failure to thrive because the constant hypoxemia (low oxygen in the blood) experienced can lead the child to have poor growth, weight loss, clubbing of the nails etc.