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1330

Cardiac catheterization performed; ventricular septal defect closed with mesh

Admit to the pediatric floor for observation

Check pedal pulses every 4 hours

Nothing by mouth

Place the child on a continuous cardiopulmonary monitor

The nurse reviews the post-catheterization orders.

What two orders would the nurse question?

Point of care blood glucose

Check pedal pulses every 4 hours

Give lactated Ringers intravenously at 66 ml/hr while NPO

Vital signs every 4 hours

Nothing by mouth

Admit to the pediatric floor for observation

Check dressing every 15 minutes for 1 hour and then every hour for

Answer and Explanation

Correct Answer : B,C

B. Check pedal pulses every 4 hours: This order should be questioned because after a ventricular septal defect closure, it is essential to assess and monitor peripheral pulses frequently, especially in the immediate post-catheterization period. Checking pedal pulses every 4 hours may not provide adequate monitoring and could potentially lead to delayed detection of complications.

C. Give lactated Ringers intravenously at 66 ml/hr while NPO: This order should be questioned because it specifies a continuous intravenous infusion of lactated Ringer's solution, but the patient is listed as "Nothing by mouth" (E). In cases where a patient is NPO, it's important to clarify the rationale for the intravenous fluid rate and consider whether it's appropriate, especially after a cardiac catheterization procedure.

The other orders are appropriate or necessary for the post-catheterization care of a child with a closed ventricular septal defect:

A. Point of care blood glucose: Monitoring blood glucose levels is relevant in post-catheterization care.

D. Vital signs every 4 hours: Monitoring vital signs is standard post-catheterization care.

F. Admit to the pediatric floor for observation: This order is appropriate for post-catheterization observation.

G. Check dressing every 15 minutes for 1 hour and then every hour: Frequent dressing checks are important for assessing and preventing bleeding or other complications at the catheterization site.

H. Place the child on a continuous cardiopulmonary monitor: Continuous monitoring is important for early detection of any cardiopulmonary issues in the post-catheterization period.

In summary, monitoring peripheral pulses and the appropriateness of intravenous fluids in relation to NPO status should be questioned in this context.

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Correct Answer is A

Explanation

A. Reactions to any previous hospitalizations can provide some insight into the child's previous healthcare experiences, but it may not be as directly relevant to planning care for an umbilical hernia repair.

B. A history of rubella, rubeola, or chicken pox is important for the child's medical history, but it may not be the most critical information when planning care for an umbilical hernia repair.

C. The mother's use of alcohol, drugs, or cigarettes during pregnancy is particularly relevant when planning care for a child undergoing surgery, as it can affect the child's overall health and potential complications during and after the procedure. Exposure to these substances during pregnancy can lead to various health issues that need to be considered in the child's care plan.

D. A list of achievement timeline for developmental milestones is important for understanding the child's developmental progress, but it may not be the primary consideration when planning care for an umbilical hernia repair.

Correct Answer is {"dropdown-group-1":"B"}

Explanation

Across the ventricular septum: This clarifies the location of the shunt, indicating that it occurs across the ventricular septum, leading to the mixing of oxygenated and deoxygenated blood.

So, the complete statement is: "Based on the child's diagnosis, he has mixed blood flow due to a left-to-right shunt across the ventricular septum."

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Naxlex Comprehensive Predictor Exams

A six-year-old girl is being admitted to the hospital for repair of an umbilical hernia. Which information, collected by the admitting nurse, is particularly helpful in planning care for this child?

Correct Answer is A

Explanation

Correct Answer is {"dropdown-group-1":"B"}

Explanation

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