Which congenital heart disease causes cyanosis when not repaired? (select all that apply)

Which intervention should be included in the plan of care for an infant with the nursing diagnosis Fluid Volume Excess related to congestive heart failure?

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis (LTB) to stay at the bedside as much as possible. What is the nurse’s primary rationale for this action?

Phase 1

A 10-week-old is brought to the emergency department with three days of rhinorrhea, congestion, and cough. He is presenting with mild intercostal retractions, congested cough, HR: 178, RR: 65 breaths/min, his capillary refill is >4 seconds, O2 Sat: 92% on RA, T- 99.2 F, wheezing is heard bilaterally, & mother feels the infant needs help breathing. Unable to stay latched to breast. Restless and has head bobbing. Mother at bedside.

Choose the most likely options for the information missing from the statements below by choosing from the corresponding list. 

Based on the infant’s assessment data, the nurse determines that the infant’s abnormal vital sign findings are most likely due to

A two-month-old infant is hospitalized for repair of a ventricular septal defect. The infant’s admitting diagnosis is moderate congestive heart failure. What signs and symptoms would you expect to see in your assessment?

Phase 1

A 5 year old is brought to her pediatrician for an annual routine checkup. Her grandparents, who are also the legal guardians, are with her. The child has not seen her pediatrician in a year. The child recently had a visit to the urgent care center and was treated for strep throat. The grandparents are concerned about the child’s weight gain. They state no matter how much she eats she cannot gain weight and is hungry all of the time. 

Phase 2

The primary care office does not have a glucometer available, so the provider orders a urinalysis dip stick test. The urinalysis shows a glucose of over 500mg/dl with blood, leukocytes, and ketones.  The results are shared with the grandparents along with the potential diagnosis and complications. The child’s grandparents are visibly upset and start asking the nurse questions about their grandchild.

Choose the most likely options for the information missing from the statements below by selecting from the lists of options provided.

Bases on the available test results the nurse suspects the child may be experiencing

Samatha, age 4, has a glucose level of 329mg/dl. She is eating the following for lunch: grilled chicken, juice(15g carb), mashed potatoes (30g carb), applesauce (15g carb). Her insulin order is as follows: 

1. Provide insulin coverage for meals at 1 unit novolog/1 carbohydrate exchange (15g carb=1 carb exchange) and,
2. Provide insulin correction for blood glucose level based on scale:

Up to 249mg/dl: no correction

250-299 mg/dl: 0.5 unit novolog 300-349 mg/dl: 1 unit novolog

350-399 mg/dl: 1.5 unit novolog

How much total insulin should Samantha receive?

You are discussing prevention of infective endocarditis with parents of a child with a complex congenital heart defect. A critical teaching point to emphasize includes:

While caring for an 18 month old male with a diagnosis of kawasaki disease, which of the following would be an indication of deterioration?

The diabetes educator has completed his teaching with a family and 13 year old child with newly diagnosed type 1 diabetes. The nurse knows the teaching has been effective when the child states:

Which congenital heart disease causes cyanosis when not repaired? (select all that apply)