Exhibits
Based on the results of the echocardiogram, the physician has decided to repair the ventricular septal via cardiac catheterization.
What should the nurse's focused assessment include before the cardiac catheterization? Select all that apply.
Measure the child's height and weight
Document lying, sitting, and standing blood pressures
Locate and mark the pedal pulses
Perform a mini mental exam on the child
Obtain a history of allergic reactions
Determine when the child last ate
Correct Answer : A,B,C,E,F
A. Measuring the child's height and weight is essential to ensure appropriate dosing of medications and to assess the child's growth and development.
B. Documenting lying, sitting, and standing blood pressures can help detect orthostatic hypotension, which may be a concern during or after the procedure.
C. Locating and marking the pedal pulses is important for assessing the vascular status of the lower extremities, especially since the catheterization involves accessing a blood vessel.
D. Performing a mini mental exam on the child is not typically part of the pre-cardiac catheterization assessment for a 3-year-old.
E. Obtaining a history of allergic reactions is crucial to prevent any potential allergic response to medications or materials used during the catheterization.
F. Determining when the child last ate is necessary because the child will need to fast for a certain period before the procedure to reduce the risk of aspiration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Frequent premature ventricular contractions: While abnormal heart rhythms are a concern, they may not warrant immediate intervention in this context unless they are causing significant hemodynamic instability.
B. Paroxysmal supraventricular tachycardia: This cardiac dysrhythmia may require intervention but is not directly related to the administration of alteplase.
C. Lower extremity edema: Lower extremity edema may indicate venous insufficiency or other underlying conditions but is not directly related to the administration of alteplase.
D. Headache with blurred vision: This could be indicative of worsening cerebral edema or increased intracranial pressure, which are potential complications of alteplase administration and require immediate intervention.
Correct Answer is ["A","B","C","E","F"]
Explanation
A. Measuring the child's height and weight is essential to ensure appropriate dosing of medications and to assess the child's growth and development.
B. Documenting lying, sitting, and standing blood pressures can help detect orthostatic hypotension, which may be a concern during or after the procedure.
C. Locating and marking the pedal pulses is important for assessing the vascular status of the lower extremities, especially since the catheterization involves accessing a blood vessel.
D. Performing a mini mental exam on the child is not typically part of the pre-cardiac catheterization assessment for a 3-year-old.
E. Obtaining a history of allergic reactions is crucial to prevent any potential allergic response to medications or materials used during the catheterization.
F. Determining when the child last ate is necessary because the child will need to fast for a certain period before the procedure to reduce the risk of aspiration.
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