A nurse has admitted a child with ventricular septal defect (VSD) to the unit. Which nursing diagnosis is appropriate for this child?

Hypothermia related to decreased metabolic state

Acute pain related to the effects of a congenital heart defect

Ineffective tissue perfusion (peripheral) related to cyanosis secondary to congenital heart defect

Impaired gas exchange related to pulmonary congestion secondary to the increased pulmonary blood flow

Answer and Explanation

The Correct Answer is C

a) Hypothermia related to decreased metabolic state: Unlikely to be directly related to VSD unless it's causing severe complications affecting metabolic function.

b) Acute pain related to the effects of a congenital heart defect: While the child might experience pain due to surgery or interventions, it's not the primary nursing diagnosis for VSD.

c) Ineffective tissue perfusion (peripheral) related to cyanosis secondary to congenital heart defect: VSD causes increased workload on the heart, leading to decreased oxygenation and potentially causing cyanosis and ineffective tissue perfusion.

d) Impaired gas exchange related to pulmonary congestion secondary to the increased pulmonary blood flow: While pulmonary congestion can occur, ineffective tissue perfusion is more directly related to cyanosis from VSD.

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Correct Answer is A

Explanation

a) A high hemoglobin: Tricuspid atresia typically leads to decreased pulmonary blood flow, causing cyanosis and chronic hypoxemia, which can result in increased hemoglobin levels as the body compensates for low oxygen.

b) A prolonged PTT: While not typically associated with tricuspid atresia specifically.

c) A low hematocrit: Hematocrit levels might be normal or elevated due to chronic hypoxemia.

d) A low platelet count: Platelet count might not be directly affected by tricuspid atresia.

A. Handwashing is the most important factor in reducing the spread of the virus B. We understand that early treatments with gamma-globulins can help our child C. We will clean contaminated surfaces with bleach D. We should feed our child a high-fat diet

Correct Answer is D

Explanation

a) Handwashing is the most important factor in reducing the spread of the virus: Correct, hand hygiene is crucial in preventing the transmission of Hepatitis A.

b) We understand that early treatments with gamma-globulins can help our child: Correct, gamma-globulin treatment can offer passive immunity.

c) We will clean contaminated surfaces with bleach: Correct, using bleach is effective in disinfecting contaminated surfaces.

d) We should feed our child a high-fat diet: Hepatitis A does not require a high-fat diet. In fact, a low-fat diet is often recommended during the acute phase of the illness to reduce stress on the liver. This statement indicates a need for further education.

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A nurse has admitted a child with ventricular septal defect (VSD) to the unit. Which nursing diagnosis is appropriate for this child?

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