The recommended dose of Lasix for a child is 1 mg/kg/dose. The child's weight is 77 pounds. The medication is supplied in 10 mg/ml. The child’s weight in kilograms is?

Choice A reason: Coarctation of the aorta causes narrowing, increasing upper body pressure and reducing lower body flow. Lower arm than leg blood pressure is incorrect, as the obstruction leads to higher arm pressure, requiring clarification of the condition’s hemodynamic effects.

Choice B reason: Equal blood pressure in arms and legs is not expected in coarctation of the aorta, where aortic narrowing causes higher pressure in the arms due to obstruction. This is incorrect, as the condition creates a pressure gradient between upper and lower extremities.

Choice C reason: Higher leg than arm blood pressure is incorrect, as coarctation of the aorta reduces blood flow to the legs, lowering leg pressure compared to arms. The nurse should expect the opposite, making this an incorrect finding for this congenital condition’s presentation.

Choice D reason: Coarctation of the aorta causes aortic narrowing, increasing blood pressure in the arms (pre-obstruction) and decreasing it in the legs (post-obstruction). This is the expected finding, making it the correct choice, as it reflects the condition’s impact on blood pressure distribution.

Choice A reason: ACE inhibitors do not primarily lower heart rate; they block angiotensin II formation, reducing vasoconstriction and blood pressure. Lowering heart rate is more characteristic of beta blockers, which decrease cardiac output. This statement is incorrect, as ACE inhibitors primarily affect vascular tone, not heart rate, in hypertension management.

Choice B reason: ACE inhibitors block angiotensin-converting enzyme, preventing angiotensin II production, which inhibits vasoconstriction and reduces peripheral resistance. This lowers blood pressure by relaxing arterioles, improving blood flow. This mechanism is central to their antihypertensive effect, making this the accurate description of their action in managing hypertension.

Choice C reason: Increasing peripheral resistance would raise blood pressure, counteracting the goal of hypertension treatment. ACE inhibitors reduce peripheral resistance by inhibiting vasoconstriction, lowering blood pressure. This statement is incorrect, as it contradicts the vasodilatory effect of ACE inhibitors, which is essential for their therapeutic role in hypertension.

Choice D reason: ACE inhibitors promote sodium excretion by reducing aldosterone production, not retention. Sodium retention increases blood volume and pressure, opposing their antihypertensive effect. This statement is incorrect, as ACE inhibitors decrease blood volume through natriuresis, contributing to blood pressure reduction in patients with hypertension.