A nurse is caring for a school-age child following a femoral venous cardiac catheterization. Which of the following actions should the nurse take?

Keep the affected extremity straight for 4 hr.

Perform a sterile dressing change 8 hr after the procedure.

Maintain NPO status for 24 hr following the procedure.

Assess the pulses above the catheterization site.

Answer and Explanation

The Correct Answer is A

A. Keep the affected extremity straight for 4 hr: Keeping the leg straight helps prevent bleeding and hematoma formation at the catheter insertion site. This is a key nursing intervention after femoral venous cardiac catheterization to promote healing and reduce complications.

B. Perform a sterile dressing change 8 hr after the procedure: The dressing is typically kept intact unless it becomes soiled or saturated. Routine dressing changes within 8 hours are not necessary and could increase the risk of infection at the insertion site.

C. Maintain NPO status for 24 hr following the procedure: Prolonged NPO status is not required after cardiac catheterization. The child can usually resume oral intake once fully awake and stable, with no nausea or vomiting present.

D. Assess the pulses above the catheterization site: Pulse assessment should focus on distal pulses below the catheterization site to ensure adequate circulation. Checking pulses above the site does not provide relevant information about perfusion to the affected extremity.

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Correct Answer is A

Explanation

A. "I saw on the internet that there's a new treatment option.": Seeking information and showing interest in possible treatment reflects active coping and problem-focused adjustment. It demonstrates hope, engagement, and willingness to explore ways to support the child.

B. "I don't want my family to know about my child's diagnosis.": Avoiding sharing important information with family members indicates denial and isolation, which can interfere with healthy coping and access to emotional or practical support.

C. "I wish I knew what I did to cause my child to be sick.": This reflects guilt and self-blame, which are common but maladaptive responses. Such thoughts can hinder acceptance and increase emotional distress rather than promoting adjustment.

D. "I am not sure how to care for my dying child.": Expressing uncertainty about caregiving demonstrates anxiety and lack of confidence. While it opens the door for teaching, it does not reflect positive coping or adjustment at this stage.

A. "The obstruction will be treated with a medication called indomethacin." B. "The cardiologist will monitor your infant closely until they are able to receive treatment with a heart transplant." C. "Most cases resolve spontaneously without treatment by 12 months of age." D. "Surgical repair is the recommended treatment for infants younger than 6 months old."

Correct Answer is D

Explanation

A. "The obstruction will be treated with a medication called indomethacin.": Indomethacin is used to close a patent ductus arteriosus, not to correct coarctation of the aorta. In fact, for coarctation, maintaining ductal patency with prostaglandin E may be necessary until surgery is performed.

B. "The cardiologist will monitor your infant closely until they are able to receive treatment with a heart transplant.": Heart transplant is not the standard treatment for coarctation of the aorta. Most infants undergo surgical or catheter-based interventions, which are effective.

C. "Most cases resolve spontaneously without treatment by 12 months of age.": Coarctation of the aorta does not resolve on its own. Without treatment, it can lead to severe complications such as heart failure, hypertension, or even death, making timely intervention critical.

D. "Surgical repair is the recommended treatment for infants younger than 6 months old.": Surgical repair is the treatment of choice for significant coarctation in infants, especially those younger than 6 months, to relieve obstruction and prevent complications such as left ventricular dysfunction and poor systemic perfusion.

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A nurse is caring for a school-age child following a femoral venous cardiac catheterization. Which of the following actions should the nurse take?

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