A nurse is collecting data from an infant who has a large patent ductus arteriosus. Which of the following is clinical manifestations should the nurse expect?

Cyanosis with crying

Weak pulses

Chronic hypoxemia

Machine-like murmur

Answer and Explanation

The Correct Answer is D

A. Cyanosis with crying: Cyanosis is less common in isolated PDA and more indicative of other congenital heart defects. PDA usually results in increased pulmonary blood flow and may not directly cause cyanosis, especially in less severe cases.

B. Weak pulses: PDA typically causes increased pulmonary blood flow and can result in bounding pulses rather than weak ones. Weak pulses are more indicative of reduced cardiac output, which is not characteristic of PDA.

C. Chronic hypoxemia: Chronic hypoxemia is less associated with PDA and more common in cyanotic heart defects where oxygenated and deoxygenated blood mix. PDA primarily affects the volume of blood flow to the lungs and may not lead to hypoxemia unless complicated by other conditions.

D. Machine-like murmur: A characteristic feature of PDA is a continuous, machine-like murmur caused by turbulent blood flow between the aorta and the pulmonary artery. This murmur is a hallmark sign of PDA and is typically heard during auscultation.

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Correct Answer is A

Explanation

A. Initiate droplet precautions. Pertussis (whooping cough) is transmitted via respiratory droplets. Droplet precautions are necessary to prevent the spread of the disease through coughs or sneezes.

B. Initiate a protective environment. A protective environment is used for patients with severe immunocompromised conditions to protect them from infections, not to prevent the spread of respiratory infections like pertussis.

C. Initiate contact precautions. Contact precautions are used for infections spread by direct or indirect contact with the patient or their environment, such as MRSA. Pertussis is spread by droplets, not by contact.

D. Initiate airborne precautions. Airborne precautions are for diseases that are spread through airborne particles, such as tuberculosis or measles. Pertussis is not airborne but spread through larger respiratory droplets.

A. Assist with administering a blood transfusion. B. Withhold opioids to avoid dependence. C. Encourage exercise. D. Initiate a 2 L/day fluid restriction.

Correct Answer is A

Explanation

A. Assist with administering a blood transfusion. Blood transfusions are often necessary in sickle cell crisis to manage severe anemia and improve oxygen delivery to tissues. This action helps alleviate the symptoms of the crisis and prevent complications.

B. Withhold opioids to avoid dependence. Opioids are essential for managing the severe pain associated with sickle cell crises. Concerns about dependence should not prevent adequate pain management in an acute setting.

C. Encourage exercise. During a sickle cell crisis, rest is crucial to reduce oxygen demand and prevent further sickling of red blood cells. Exercise is contraindicated during a crisis.

D. Initiate a 2 L/day fluid restriction. Adequate hydration is critical in managing sickle cell crisis, as it helps prevent further sickling of cells. Fluid restriction is inappropriate and could worsen the condition.

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A nurse is collecting data from an infant who has a large patent ductus arteriosus. Which of the following is clinical manifestations should the nurse expect?

Nursing Test Bank

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