An 8-year-old patient presents to his clinic, complaining of dizziness, headaches, and epistaxis. The nurse took the patient's vital signs and noticed that he had high blood pressure in his arms and bounding upper extremity pulses; however, when she proceeded to check his lower extremity pulses, they were weak, and his legs were pale and cool to touch. What does this patient present signs of?
Tetralogy of Fallot
Coarctation of the Aorta
Pulmonic Stenosis
Tricuspid Atresia
The Correct Answer is B
Coarctation of the aorta is a congenital heart defect where the aorta, the major blood vessel that carries oxygenated blood from the heart to the body, is narrowed. As a result, blood pressure tends to be higher in the arms and upper body but lower in the lower body, including the legs. This condition can lead to symptoms such as dizziness, headaches, and even nosebleeds due to high blood pressure. Weak or absent lower extremity pulses, as well as pale and cool legs, are characteristic physical findings in coarctation of the aorta.
A. Tetralogy of Fallot: This is a different congenital heart defect characterized by a combination of four specific heart defects, including ventricular septal defect, right ventricular hypertrophy, pulmonary stenosis, and an overriding aorta. It typically does not cause the symptoms described in the scenario.
C. Pulmonic Stenosis: This condition involves the narrowing of the pulmonary valve or artery, leading to restricted blood flow from the right ventricle to the pulmonary artery. While it can cause various symptoms, it typically doesn't cause the specific blood pressure discrepancies described.
D. Tricuspid Atresia: This is a congenital heart defect where the tricuspid valve is absent or abnormally developed. It leads to the mixing of oxygenated and deoxygenated blood in the heart. While it can cause cyanosis (bluish skin due to low oxygen levels), it doesn't typically cause the specific blood pressure findings mentioned.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","E"]
Explanation
The findings that indicate a diagnosis of Acute Kidney Injury (AKI) in a 5-year-old patient are:
A. Peripheral Edema: Peripheral edema, or swelling in the extremities, can be a sign of fluid retention due to impaired kidney function in AKI.
E. Oliguria: Oliguria, which is a decreased urine output, is a common sign of AKI. It can be defined as a urine output of less than 0.5 mL/kg/hour in children.
The other findings mentioned (B, C, and D) do not specifically indicate a diagnosis of AKI:
B. Blood pressure of 112/70: The blood pressure within this range is not necessarily indicative of AKI on its own.
C. Potassium level of 4.7 (normal: 3.5-5.0 mmol/L): While abnormal potassium levels can be associated with AKI, a potassium level of 4.7 mmol/L is within the normal range.
D. Diarrhea: Diarrhea is not typically a direct symptom of AKI but may be seen in various other conditions or as a result of electrolyte imbalances associated with kidney dysfunction.
Correct Answer is B
Explanation
When obtaining the history of a child with suspected rheumatic fever, the nurse should consider the following information to be most significant:
B. A recent episode of pharyngitis.
Explanation:
Rheumatic fever often follows an untreated or inadequately treated streptococcal pharyngitis (strep throat) infection caused by Group A Streptococcus bacteria. Therefore, a recent episode of pharyngitis is a key piece of information in the context of rheumatic fever. It is important to assess whether the child had a sore throat, fever, and other symptoms of streptococcal infection that may have triggered the development of rheumatic fever.
While the other symptoms (vomiting, lack of interest in food, fever) may be important for the overall assessment and management of the child, they are not as directly associated with the development of rheumatic fever as a recent episode of pharyngitis caused by Group A Streptococcus. Rheumatic fever is an autoimmune response to untreated streptococcal infection, and its diagnosis is often linked to the presence of preceding streptococcal pharyngitis.
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