An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). The nurse understands dyspnea occurs because blood
Shunted past the pulmonary circulation, causing pulmonary hypoxia
Circulated through the lungs again, causing pulmonary circulatory congestion
Circulated through the ductus from the pulmonary artery to the aorta bypassing the left side of me heart
Shunted past cardiac arteries, causing myocardial hypoxia
The Correct Answer is C
A. Shunted past the pulmonary circulation, causing pulmonary hypoxia: This option is not the primary reason for dyspnea in PDA. While there is shunting, it doesn't directly cause pulmonary hypoxia.
B. Circulated through the lungs again, causing pulmonary circulatory congestion: This option is partially correct but does not address the primary reason for dyspnea, which is the bypassing of the left side of the heart.
C. Circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart.
In patent ductus arteriosus (PDA), a fetal blood vessel called the ductus arteriosus fails to close after birth. This allows oxygenated blood from the left atrium to be shunted directly from the aorta to the pulmonary artery, bypassing the normal route through the left side of the heart and into the systemic circulation. The shunting of oxygenated blood back into the pulmonary circulation can lead to increased pulmonary blood flow and circulatory congestion, causing symptoms such as dyspnea.
D. Shunted past cardiac arteries, causing myocardial hypoxia: PDA primarily affects the pulmonary circulation and left side of the heart, not the coronary arteries. Myocardial hypoxia is not the primary mechanism of dyspnea in PDA.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "You can give your child acetaminophen (Tylenol) every 4-6 hours as needed for pain."
Option A is the most appropriate response because it addresses pain management, which is a common symptom in cases of tonsillitis. Acetaminophen can be used to provide relief from pain and fever, which are often associated with viral tonsillitis. However, it's important for the parent to follow the dosing instructions on the medication label and consult with their healthcare provider if they have any concerns or if the child's condition worsens.
Option B ("You will need to schedule a follow-up appointment in 2 weeks") is also not the best initial response, as it doesn't address immediate care at home for the child's comfort and pain relief.
Option C ("You will need to give your child a prescribed antibiotic for 10 days") is not the correct approach, as antibiotics do not treat viral illnesses. Viral tonsillitis is usually caused by a viral infection, and antibiotics are not effective for viral infections.
Option D ("You can place warm towels around your child's neck for comfort") can provide some comfort but is not the primary treatment for viral tonsillitis. It may help alleviate discomfort, but pain relief with acetaminophen is typically more effective.
Correct Answer is D
Explanation
A. Checking urine for glucose and protein is not directly related to the care of a child with a VP shunt. The focus is on monitoring the child for signs of complications related to the shunt.
B. Administering narcotics for pain control may be indicated if the child is in pain, but it is not the primary action and should be determined based on the child's pain assessment.
C. Testing cerebrospinal (CSF) fluid leakage for protein is not typically a nursing responsibility in the immediate postoperative period. Leakage of CSF should be reported to the healthcare provider, and diagnostic tests would be conducted by medical staff as needed.
D. Monitor for increased temperature.
Monitoring for an increased temperature is essential because postoperative fever could be an early sign of infection or complications related to the VP shunt. Infection and shunt malfunction are potential risks in the postoperative period.
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