FREE Pediatric CCRN from AACN Questions and Answers
Which condition is caused by the presence of a large, isolated patent ductus arteriosus (PDA) where the ductus fails to close normally?
Blood shunts from left to right into the pulmonary artery (PA) and lungs in isolated PDA. When the PVR decreases and the aortic pressure rises over the PA, this happens. The size, diameter, degree of shunting, compensatory mechanisms, and stage of lung development all affect clinical appearance. The existence of a large PDA results in low diastolic pressure, leading to low cardiac output and poor coronary perfusion. To regain adequate diastolic pressure and myocardial perfusion, a surgical closure is necessary.
Discharge instruction is the responsibility of respiratory, physical, and occupational therapists and nurses; each profession now keeps track of this information on a separate flow sheet. The following would be the ideal scenario for organizing teaching:
The best way to coordinate teaching among respiratory therapists, physical therapists, occupational therapists, and nurses would be to have all disciplines document patient teaching on the same flow sheet.
A newborn with transposed great arteries is hospitalized. 46% is the SpO2 value. Nobody makes a murmur. Which drugs should the nurse anticipate being given as a stopgap measure until a balloon septostomy can be performed?
In the case of a newborn with transposition of the great arteries, a temporary measure to improve oxygenation and stabilize the condition before a balloon septostomy is performed is the administration of alprostadil (PGE1).
Clinical indicators seen in a kid who has been given the diagnosis of failure to thrive include
Clinical manifestations observed in a child diagnosed with failure to thrive may include avoidance of eye contact and delayed motor development.
Failure to thrive refers to a condition in which a child's growth and development fall significantly below expected norms for their age. It is typically characterized by inadequate weight gain or weight loss, along with poor or delayed physical and developmental progress.
While patients are sleeping, a nursing unit must be able to put patients back on ventilator support as directed. The respiratory therapist is only sometimes present on the unit to put patients on the ventilator because of staffing patterns. The nurse should respond in the following ways:
As a nurse, it is essential to advocate for patient safety and the best possible care. If the current policy dictates that only respiratory therapists can manage the ventilator and there are instances when the therapist is not available on the unit, it is appropriate for the nurse to question this policy.
A juvenile patient who has third-degree burns from an apartment fire and is in septic shock is being admitted by a nurse to the PICU. Which of the following treatments is the nurse planning to administer first?
In the event of septic shock, IV fluids will be started right once to replenish volume since circulation and perfusion are priorities. The SVR is then raised and blood vessel dilatation is decreased using vasoactive drugs. Immediately following the collection of blood cultures, broad-spectrum antibiotics are administered. Septic shock, which causes adrenal insufficiency and resistant hypotension, is treated with steroids.
A nurse provides medical attention to a little child in the pediatric intensive care unit (PICU) who has had a cardiac catheterization to repair a ventricular septal defect (VSD). What kind of heart arrhythmia is the MOST typical to develop as a side effect of VSD repair?
Heart block refers to an abnormality in the heart's electrical conduction system, which can disrupt the transmission of electrical impulses between the atria and ventricles, leading to an irregular heart rhythm. It is a well-known potential complication after VSD repair procedures, especially if the procedure involves manipulation near the heart's electrical pathways.
Esophageal varices that are bleeding may be treated acutely by:
The acute treatment of bleeding esophageal varices includes the administration of octreotide (Sandostatin).
Which disease is frequently linked to pulmonary hypertension (PH) in most pediatric patients?
Although PH is linked to various disorders across the lifetime, it is most frequently observed in children who also have CHD (underlying cardiac disease). Thromboembolic disease or connective tissue disorders have rarely ever been linked to PH. It could also be hereditary or idiopathic.
Which of the following graft types is frequently derived from cadaver skin and is frequently utilized in the treatment of pediatric burn wounds?
A biological dressing and skin transplant made from a biological donor (typically cadaver) tissue are known as allografts. Until a permanent form of wound closure can be used to cover the area, these grafts offer a temporary wound covering.
The ICU cares for an end-stage pituitary adenoma patient with diabetes insipidus and aspiration pneumonia. The mother is giving the patient water and soft beverages despite being aware that there is a plan for transpyloric tube feedings and nothing by mouth. What action should the nurse take in this circumstance?
An appropriate response by the nurse in this situation would be to question the current policy that only respiratory therapists can manage the ventilator. Given the staffing patterns and the need for patients to be placed back on ventilator support, it may be necessary to reconsider the policy and explore alternative solutions.
Extreme dyspnea is being experienced by a 2-year-old with left-sided ventricular heart failure and pulmonary edema. Which of the following would the nurse advise doing to help the youngster breathe easier and feel less anxious and agitated?
In a 2-year-old with left-sided ventricular heart failure and pulmonary edema experiencing extreme dyspnea, the nurse may suggest administering morphine (Duramorph) to improve the work of breathing and decrease the child's anxiety and agitation.
Morphine is a medication commonly used in acute heart failure situations to relieve dyspnea and anxiety. It acts as a vasodilator and reduces preload and afterload, which helps to decrease the workload on the heart and improve oxygenation.
When patient attributes and nursing competencies are aligned, optimal outcomes in terms of the AACN Synergy Model for Patient Care occur. From the standpoint of the patient and family, outcomes should contain everything listed below, EXCEPT:
The qualities and requirements of patients and their families influence nurses' abilities. According to this paradigm, synergy happens when people cooperate to achieve a common objective, and the most effective results come from an active cooperation between the patient and the nurse. From a nursing perspective, the result would be physiologic changes.
EMS reportedly transported a 4-year-old boy to the ER after he reportedly ingested some of his mother's prescribed diazepam (Valium). Which of the following is employed as a countermeasure to the drug's probable toxicity?
Flumazenil works as a competitive antagonist at the benzodiazepine receptor sites, blocking the effects of benzodiazepines and reversing their sedative and respiratory-depressant actions.
During the postictal phase of a tonic-clonic seizure characterized by uncontrollable limb jerking and loss of consciousness, a nurse is providing postictal care for a 7-year-old male patient in the PICU. What results can be anticipated from this phase?
Given the severity of the seizure of the kid, it is normal for them to feel worn out or even sleepy at this time. Symptoms like nausea and headaches are extremely typical. The best course of action at this stage is to let the youngster sleep while constantly monitoring him.
A nurse is gathering materials to start intravenous (IV) fluid resuscitation and a blood transfusion using packed red blood cells (PRBCs) as she gets ready to admit a child with a new diagnosis of sickle cell disease (SCD). Why is it necessary to use these interventions?
Treatment for the severe anemia and dehydration that frequently accompany SCD includes both IV fluid replacement and transfusion therapy.