A newborn with transposition of the great arteries, a life threatening cardiac defect, is being admitted to the unit. The nurse should anticipate an order to administer
Digoxin
Prostaglandin E
Furosemide
Indomethacin
The Correct Answer is B
Rationale:
A. Digoxin: Digoxin is used to improve cardiac contractility in heart failure but does not address the underlying anatomical defect in transposition of the great arteries (TGA). It is not the first-line treatment to maintain oxygenation in TGA.
B. Prostaglandin E: Prostaglandin E is administered to keep the ductus arteriosus open, allowing mixing of oxygenated and deoxygenated blood, which is critical for survival in newborns with TGA before corrective surgery.
C. Furosemide: Furosemide is a diuretic used to manage fluid overload and heart failure symptoms, but it does not address the fundamental need to maintain ductal patency in TGA.
D. Indomethacin: Indomethacin is used to close a patent ductus arteriosus, which would be harmful in TGA where keeping the ductus arteriosus open is necessary for adequate oxygenation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","E"]
Explanation
Rationale:
A. Diaphoresis while eating: Excessive sweating during feeding is a common sign of increased cardiac workload in infants. It indicates that the infant is struggling to meet oxygen demands due to a possible heart problem.
B. Small stature for age: Poor growth or failure to thrive often occurs in infants with cardiac issues because their bodies use extra energy to maintain adequate circulation, leading to inadequate weight gain and growth.
C. Poor social development: While important to assess, poor social development is generally not a direct indicator of cardiac issues in infants and may be related to other neurological or environmental factors.
D. Warm extremities: Warm extremities typically indicate good peripheral perfusion. In cardiac problems, extremities are often cool or mottled due to poor circulation.
E. Cyanosis: Cyanosis, or bluish discoloration of the skin and mucous membranes, is a classic and important sign of cardiac defects that cause decreased oxygenation of blood, especially in congenital heart disease.
Correct Answer is B
Explanation
Rationale:
A. Offer a complex carbohydrate snack: Complex carbohydrates take longer to digest and raise blood glucose more slowly. In early hypoglycemia, immediate action with simple carbohydrates is preferred to quickly raise blood glucose.
B. Give 10 to 15 grams of a simple carbohydrate: Simple carbohydrates, such as glucose tablets or juice, provide rapid absorption and quick elevation of blood glucose, which is essential in treating mild to moderate hypoglycemia promptly to prevent progression.
C. Administer glucagon intramuscularly: Glucagon is reserved for severe hypoglycemia when the patient is unconscious or unable to swallow. Since the child is coherent and able to communicate, oral glucose administration is the first-line treatment.
D. Administer a sliding-scale dose of insulin: Insulin lowers blood glucose and would worsen hypoglycemia. It is contraindicated when the blood sugar is low and the patient shows symptoms of hypoglycemia.
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