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For the child with transposition of the great vessels, which drug may be given to allow the Patent Ductus Arteriosus (PDA) to remain open until surgery?

A.

Digoxin

B.

Ibuprofen (Motrin)

C.

Prostaglandin E

D.

Indomethacin (Indocin)

Answer and Explanation

The Correct Answer is C

A. Digoxin is used to strengthen cardiac contractions and treat heart failure, but it does not maintain ductal patency.
B. Ibuprofen is a prostaglandin inhibitor, and would actually cause closure of the PDA, which is contraindicated in transposition of the great vessels.
C. Prostaglandin E (such as alprostadil) is administered to keep the ductus arteriosus open, allowing mixing of oxygenated and deoxygenated blood to improve oxygenation until surgical correction is performed.
D. Indomethacin is also a prostaglandin inhibitor used to close a PDA, not keep it open.


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Correct Answer is D

Explanation

A. Cromolyn sodium is a mast cell stabilizer, not a corticosteroid. It is used for preventing asthma symptoms, but it is not a corticosteroid and is less commonly used now.
B. Levalbuterol is a short-acting beta-agonist (SABA) and used as a rescue medication, not for long-term prevention.
C. Terbutaline is a beta-2 agonist and may be used for rescue or emergency use, especially in status asthmaticus, but not a corticosteroid or daily controller.
D. Budesonide (Pulmicort) is an inhaled corticosteroid used regularly as a controller medication to prevent asthma attacks by reducing airway inflammation. It is not used for acute relief, but rather for long-term management of asthma.

Correct Answer is D

Explanation

A. Depression is a common response to all types of grief, but it is not unique to traumatic loss.
B. Denial is one of the stages of grief, but again, it is not specific to traumatic loss.
C. Anger may occur with any type of grief, but it does not distinguish traumatic loss from anticipated loss.
D. Guilt is often intensely experienced in traumatic loss, particularly when the loss is sudden and unexpected. Survivors may blame themselves or question their actions, wondering if they could have done something to prevent the death, which is less common in prolonged or anticipated loss.

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