A 3-year-old child with congestive heart failure resulting from an underlying congenital heart defect, is prescribed digoxin and furosemide. Which of the following assessment findings are MOST concerning?

A blood pressure of 100/56 and a small weight gain

A heart rate of 150 beats/minute with crying

An apical pulse of 70 beats/minute and vomiting

An hourly urine output of 45mL/hour

Answer and Explanation

The Correct Answer is C

A. A blood pressure of 100/56 and a small weight gain may indicate fluid retention, but they are not immediately life-threatening.
B. A heart rate of 150 beats/minute with crying can be normal for a child of this age, especially during emotional distress.
C. An apical pulse of 70 beats/minute and vomiting are concerning because they may indicate digoxin toxicity. A low heart rate (bradycardia) in a child on digoxin requires immediate attention.
D. An hourly urine output of 45 mL/hour is adequate and not concerning in this context.

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Free Nursing Study Resources

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"C"}}

Explanation

Monitor RLE pulses with vital signs:
Anticipated. Regular monitoring of pulses, especially in areas of pain or tenderness, is essential to assess for adequate perfusion and circulation, which can be compromised in vaso-occlusive crisis.
Administer Oxycodone 3 mg Q3-4 hours PRN for pain:
Anticipated. Pain management is crucial in treating vaso-occlusive crises. Continuation of pain medication is necessary to keep the child's pain under control.
Continue IV NSS bolus @ 67 ml/hour:
Anticipated. Hydration is vital in managing a vaso-occlusive crisis as it helps to reduce blood viscosity and prevent further sickling of red blood cells.
Decrease O2 to 2 L/min:
Contraindicated. Maintaining adequate oxygenation is important in managing vaso-occlusive crises to ensure that tissues receive sufficient oxygen and to prevent further sickling of red blood cells. Decreasing oxygen flow can compromise oxygen delivery.

A. 75 mg B. 150 mg C. 60 mg D. 300 mg

Correct Answer is A

Explanation

Convert weight to kg: 11 lbs ÷ 2.2 = 5 kg. Calculate total daily dose: 60 mg/kg/day × 5 kg = 300 mg/day. Divide the total daily dose by the number of doses per day: 300 mg/day ÷ 4 (every 6 hours) = 75 mg per dose

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A 3-year-old child with congestive heart failure resulting from an underlying congenital heart defect, is prescribed digoxin and furosemide. Which of the following assessment findings are MOST concerning?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"C"}}

Explanation

Correct Answer is A

Explanation

The nurse is preparing to administer the daily maintenance dose of digoxin to an infant: Infant's Weight: 5kg Order: Administer 4mcg/kg/day Safe Dose: 3.4 to 5.1 mcg/kg/day Label: 0.25 mg/5mL

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