The Foley Family is caring for their youngest child, Justin, who is suffering from tetralogy of Fallot. Which of the following are defects associated with this congenital heart condition?
Coarctation of aorta, aortic valve stenosis, mitral valve stenosis, and patent ductus arteriosus
Ventricular septal defect, overriding aorta, pulmonic stenosis (PS), and right ventricular hypertrophy
Aorta exits from the right ventricle, pulmonary artery exits from the left ventricle, and two noncommunicating circulations
Tricuspid valve atresia, atrial septal defect, ventricular septal defect, and hypoplastic right ventricle
The Correct Answer is B
Tetralogy of Fallot is a congenital heart defect characterized by four specific abnormalities:
Ventricular septal defect (VSD): This is a hole in the wall (septum) between the two lower chambers (ventricles) of the heart.
Overriding aorta: The aorta is positioned over both the left and right ventricles, which allows oxygen-poor (deoxygenated) blood from the right ventricle to be pumped into the aorta and to the body.
Pulmonic stenosis (PS): This is a narrowing of the pulmonary valve or artery that restricts blood flow from the right ventricle to the lungs.
Right ventricular hypertrophy: The right ventricle becomes thicker and more muscular as it works harder to pump blood against the narrowed pulmonary valve or artery.
Options A, C, and D describe different congenital heart conditions and defects, but they are not associated with Tetralogy of Fallot:
A. Coarctation of aorta, aortic valve stenosis, mitral valve stenosis, and patent ductus arteriosus are not part of the constellation of defects seen in the Tetralogy of Fallot.
C. Describing the aorta exiting from the right ventricle and pulmonary artery exiting from the left ventricle with two noncommunicating circulations is characteristic of transposition of the great arteries, not Tetralogy of Fallot.
D. Tricuspid valve atresia, atrial septal defect, ventricular septal defect, and hypoplastic right ventricle describe a different congenital heart condition, not Tetralogy of Fallot.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Cardioversion involves delivering an electrical shock to the heart to restore a normal rhythm. While it may be used for certain types of tachyarrhythmias in adults, it is typically not the first-line treatment for SVT in pediatric patients.
In pediatric patients with SVT, the initial management options often include:
B. Vagal maneuvers: Non-invasive maneuvers like the Valsalva maneuver or carotid sinus massage can be attempted to try and break the SVT rhythm.
C. Adenosine: Adenosine is often the first-line medication used for terminating SVT in pediatric patients. It is given intravenously in a controlled setting under medical supervision.
D. Continue to monitor for 30 minutes: After successful termination of SVT, it's important to continue monitoring the child's heart rhythm and vital signs to ensure that the arrhythmia does not recur.
In pediatric patients, the decision to use cardioversion is usually reserved for situations where other methods, including medications and vagal maneuvers, have not been successful or if the child is unstable. Cardioversion in pediatric patients is performed under sedation or anesthesia to minimize discomfort.
Therefore, while cardioversion may be used in some cases, it is not the initial or most common approach for treating SVT in pediatric patients, making option A the answer to the question.
Correct Answer is A
Explanation
Infants with congenital heart defects, including VSD, may have increased caloric needs due to the added work of their hearts. Congestive heart failure can lead to poor weight gain and failure to thrive. Therefore, increasing the caloric density of the formula is a common approach to providing the necessary nutrition for growth and development. This can be achieved by using specialized high-calorie infant formulas or fortifying breast milk.
The other options are not the primary supportive measures for an infant with congestive heart failure in this context:
B. Oxygen therapy to ensure oxygen saturation is > 98%: While oxygen therapy may be necessary for infants with congenital heart defects, it is not the primary supportive measure to address failure to thrive. Oxygen therapy primarily aims to ensure adequate oxygenation but does not directly address caloric intake.
C. Sedatives to keep the infant from crying: The use of sedatives is not a typical approach to managing congestive heart failure in infants. Addressing the underlying cause, optimizing nutrition, and providing supportive care are more appropriate strategies.
D. Emergent surgical correction of the defect: Surgical correction of a VSD is typically considered for specific indications, such as significant hemodynamic compromise, but it is not the first-line intervention for all cases of VSD, especially if the primary concern is failure to thrive. Treatment decisions for VSD are made based on the specific clinical presentation and severity of the defect.
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