A 2 week old patient in the NICU has a 'machine like murmur, poor growth and bounding pulses. He has been diagnosed with a Patent Ductus Arteriosus. What medication would the nurse anticipate administering to this patient?
Digoxin
Prostaglandin
Furosemide
Indomethacin
The Correct Answer is D
Rationale:
A. Digoxin: Digoxin is used to improve cardiac contractility and manage heart failure symptoms, but it does not promote closure of the patent ductus arteriosus (PDA). It may be part of supportive care but is not the primary treatment for PDA.
B. Prostaglandin: Prostaglandins keep the ductus arteriosus open, which is useful in some congenital heart defects requiring ductal patency. However, in PDA, the goal is to close the ductus, so prostaglandin administration would be contraindicated.
C. Furosemide: Furosemide is a diuretic used to manage fluid overload and heart failure symptoms but does not affect ductus arteriosus closure. It may be used adjunctively if heart failure develops.
D. Indomethacin: Indomethacin is a nonsteroidal anti-inflammatory drug that inhibits prostaglandin synthesis, promoting closure of the patent ductus arteriosus. It is the first-line medication used to medically close PDA in neonates.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E","G"]
Explanation
Rationale:
A. Metformin twice a day, taken with food to prevent GI upset: Metformin is the first-line medication for Type 2 Diabetes and helps improve insulin sensitivity. Taking it with food reduces gastrointestinal side effects, making this a key part of treatment.
B. Long acting lantus before bed to control blood sugar overnight: While insulin may be necessary in some Type 2 Diabetes cases, especially with significant hyperglycemia, it is not typically the initial treatment for newly diagnosed adolescents. It is more common in Type 1 Diabetes or advanced Type 2.
C. Rapid Acting Insulin dosed using a sliding scale before every meal: Sliding scale insulin is generally reserved for Type 1 Diabetes or severe cases of Type 2 Diabetes with uncontrolled glucose. It is not the standard initial treatment in newly diagnosed Type 2 adolescents.
D. Consistent aerobic exercise every day with a goal of 60 minutes per day: Regular physical activity is essential in managing Type 2 Diabetes as it improves insulin sensitivity and aids in weight management.
E. Regular blood sugar monitoring throughout the day: Monitoring blood glucose levels helps track the effectiveness of treatment and guides lifestyle or medication adjustments in Type 2 Diabetes management.
F. Use of a continuous subcutaneous insulin pump to control blood sugar: Insulin pumps are typically used for Type 1 Diabetes. Their use in Type 2 Diabetes is rare and usually reserved for specific cases, not standard treatment.
G. Well balanced diet and monitoring simple sugar intake: Dietary management focusing on balanced nutrition and limiting simple sugars is fundamental in controlling Type 2 Diabetes and preventing glucose spikes.
Correct Answer is D
Explanation
Rationale:
A. Suprasternal retractions occurs at the notch above the sternum, not below it.
B. Supraclavicular retractions are seen above the clavicles, often with severe distress.
C. Intercostal retractions appear between the ribs, not beneath the sternum.
D. Substernal retractions occur just below the sternum when the child is working hard to breathe.
E. Subcostal retractions are located beneath the rib cage, closer to the abdomen, not at the sternum.
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