Exam 3 Objectives

Question 1

What is preload?

Answer 1

Volume of blood in the ventricle before it contracts

Preload is the end-diastolic volume that stretches the ventricles to their greatest dimensions.

Question 2

What is afterload?

Answer 2

Resistance the heart must overcome to open the aortic valve

Afterload is the force against which the heart must pump blood.

Question 3

What is contractility?

Answer 3

The ability of the heart muscle to contract

Contractility influences stroke volume along with preload and afterload.

Question 4

What three factors affect stroke volume?

Answer 4

Preload, Afterload, Contractility

Question 5

What is S3 in children?

Answer 5

Normal finding—related to rapid filling of the ventricle

Question 6

What heart sound is abnormal in CHF?

Answer 6

S4

Question 7

What do you look for in pediatric cardiac assessment?

Answer 7

Skin color, pulses, heart sounds, cap refill, cyanosis, breathing, feeding

Question 8

What are common causes of congenital heart defects?

Answer 8

Genetics, maternal infections, metabolic disorders, drug exposure

Question 9

What are the four defects in Tetralogy of Fallot?

Answer 9

VSD, Pulmonary Stenosis, Right Ventricular Hypertrophy, Overriding Aorta

Question 10

What is a “Tet Spell”?

Answer 10

Sudden cyanotic episode in TOF, relieved by knee-chest position

Question 11

What defect is associated with a continuous ‘machinery’ murmur?

Answer 11

PDA

Question 12

Which congenital heart defect shows bounding upper pulses and weak femoral pulses?

Answer 12

Coarctation of the Aorta (CoA)

Question 13

Which congenital heart defect shows cyanosis that doesn’t improve with oxygen?

Answer 13

Transposition of the Great Arteries (TGA)

Question 14

What do you give to keep the ductus arteriosus open in critical defects?

Answer 14

Prostaglandin E (PGE)

Question 15

What are the three stages of Kawasaki disease?

Answer 15

Acute (fever), Subacute (skin changes, aneurysms), Convalescent

Question 16

What is the treatment for Kawasaki disease?

Answer 16

IVIG, high-dose aspirin

Question 17

What is the main nursing concern in Kawasaki disease?

Answer 17

Monitor for coronary artery aneurysms

Question 18

What causes hypovolemic shock?

Answer 18

Hemorrhage, dehydration, burns, DKA

Question 19

Is BP a good early indicator in shock?

Answer 19

No, not until late stage

Question 20

What are signs of hypovolemic shock?

Answer 20

Tachycardia, poor perfusion, ↓ urine output, cool extremities

Question 21

What is the initial treatment for hypovolemic shock?

Answer 21

IV fluid bolus, warmth, reassess frequently

Question 22

What is the priority after a cardiac catheterization?

Answer 22

Monitor site, distal pulses, and keep extremity straight

Question 23

What is the TEN-4 rule regarding bruising?

Answer 23

Bruising on torso, ears, neck in under-4 years; ANY bruising in <6 months = concerning

Question 24

What are red flags in the history for physical abuse?

Answer 24

No or vague explanation for injury, delayed care, inconsistent stories

Question 25

What should be documented in suspected abuse cases?

Answer 25

Objective notes: location, size, color, shape, pattern

Question 26

What is the most common age group for pediatric poisoning?

Answer 26

Ages 1–5

Question 27

What is the nursing management for pediatric poisoning?

Answer 27

ABCs, prevent further absorption, reverse effects, enhance elimination

Question 28

What are common poisons in pediatrics?

Answer 28

Salicylates, Acetaminophen, Iron, Cholinergic Agents, Anticholinergic Agents

Question 29

What are signs of lead poisoning?

Answer 29

Often silent; long-term: ↓ IQ, hearing issues, growth delay

Question 30

What is the treatment for lead poisoning?

Answer 30

Remove exposure, chelation therapy

Question 31

What is a key sign of adequate perfusion in patients?

Answer 31

Normal urine output ## Footnote Normal urine output indicates that the kidneys are receiving adequate blood flow.

Question 32

What is the priority nursing action for an infant with Kawasaki disease in the acute stage?

Answer 32

Administer high-dose aspirin and IVIG ## Footnote IVIG and aspirin are crucial to reduce the risk of coronary artery damage.

Question 33

Which symptom during the subacute phase of Kawasaki disease is most concerning?

Answer 33

A new gallop rhythm ## Footnote A gallop rhythm may indicate potential heart failure or aneurysm complications.

Question 34

What condition is indicated by a pulmonary artery arising from the left ventricle and the aorta from the right ventricle?

Answer 34

Transposition of the great arteries (TGA) ## Footnote This condition requires intervention to ensure proper oxygenation.

Question 35

What is the priority intervention for an infant with TGA presenting with cyanosis?

Answer 35

Initiate prostaglandin E infusion ## Footnote PGE is necessary to keep the ductus arteriosus open for mixing oxygenated blood.

Question 36

Fill in the blank: The treatment standard for Kawasaki disease includes high-dose aspirin and _______.

Answer 36

IVIG ## Footnote IVIG stands for intravenous immunoglobulin, which is essential in treatment.

Question 37

True or False: Peeling skin on fingers is the most concerning symptom during the subacute phase of Kawasaki disease.

Answer 37

False ## Footnote While peeling skin can occur, a new gallop rhythm is more concerning.

Question 38

What should a nurse monitor closely in a child with Kawasaki disease during the subacute phase?

Answer 38

Heart rhythm ## Footnote Monitoring heart rhythm is critical to detect potential complications.

Question 39

What does a new gallop rhythm indicate in a patient?

Answer 39

Possible heart failure or aneurysm complications ## Footnote A gallop rhythm can signify significant cardiac issues.