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

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.

Which of the following responses by the nurse are appropriate? (Select all that apply)

Which type of respiratory condition is always considered an emergency?

Aspirin is a part of the treatment for children with Kawasaki disease.

A three-year-old, is admitted to the pediatric medical unit with acute kawasaki disease. What signs and symptoms are you most likely to note as you do your intake assessment?

What nursing action is appropriate to take when an infant with a congenital heart defect has increased respiratory rate, is sweating, and is not feeding well?

Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis?

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?

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

American academy of pediatrics states taht breastfeeding should be avoided for children with congenital heart disease because it requires less energy to suck from a bottle than the breast.

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.

Select and highlight the assessment findings that require follow up.

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.

Medical History

Up to date with vaccine

No known allergies

Born at 39 weeks