The nurse assesses a child with coarctation of the aorta. Which common clinical manifestation is the nurse likely to observe?
Upper body blood pressure is higher than the lower body
Clubbing of the digits and shortness of breath
Cyanosis
Pedal edema
The Correct Answer is A
A. Coarctation of the aorta is a congenital narrowing of the aorta, typically after the branches that supply the upper body. This results in increased blood pressure in the upper extremities and decreased perfusion (and lower blood pressure) in the lower extremities.
B. Clubbing and shortness of breath are more characteristic of chronic hypoxemia, often seen in cyanotic congenital heart defects such as Tetralogy of Fallot, not coarctation of the aorta.
C. Cyanosis is typically associated with defects that cause mixing of oxygenated and deoxygenated blood, such as transposition of the great arteries or tetralogy of Fallot, not coarctation.
D. Pedal edema is more commonly associated with right-sided heart failure and is not a hallmark sign of coarctation in pediatric clients.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. While an erythematous rash (erythema marginatum) is a common finding in rheumatic fever, it is not immediately life-threatening and does not take priority over cardiac assessment.
B. The greatest risk in acute rheumatic fever is carditis, which can lead to valvular heart damage, heart failure, or arrhythmias. Therefore, auscultating heart rate and heart sounds (for murmurs, gallops, friction rubs) is a priority to detect early signs of cardiac involvement.
C. Parental anxiety is important to address, but physiological stability of the child takes precedence during initial admission.
D. Joint pain is common in rheumatic fever, but it is not life-threatening and can be assessed after the cardiac evaluation is complete.
Correct Answer is A
Explanation
A. Bright red blood indicates active arterial bleeding, most likely from the femoral artery used during the cardiac catheterization. The first priority is to stop the bleeding. Direct pressure should be applied just above the puncture site to help control the bleeding and prevent further blood loss.
B. While notifying the Cath Lab may be necessary later, intervention to stop the bleeding must come first to ensure patient safety.
C. Contacting the Interventional Radiologist may eventually be required, but it is not the first action. Immediate pressure to control bleeding is more urgent.
D. Applying a bulky dressing alone without direct pressure is inadequate in managing arterial bleeding and may delay life-saving intervention.
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