A child with congestive heart failure is started on Captopril because its primary effect is
slows the heart rate thus increasing diastolic filling time
increases urine output thus decreasing pulmonary congestion
decreases the afterload thus decreasing the workload on the heart
increases serum potassium thus improving cardiac performance
The Correct Answer is C
Choice A reason: Slowing the heart rate does not increase diastolic filling time. Diastolic filling time is the time during which the ventricles are relaxed and filling with blood. Slowing the heart rate would decrease the cardiac output and worsen the heart failure.
Choice B reason: Increasing urine output does decrease pulmonary congestion, but it is not the primary effect of Captopril. Captopril is an angiotensin-converting enzyme (ACE) inhibitor, which blocks the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This reduces the blood pressure and the afterload on the heart. Diuretics are the drugs that increase urine output and reduce fluid overload.
Choice C reason: This is the correct choice. Decreasing the afterload means reducing the resistance that the heart has to overcome to pump blood to the body. This lowers the blood pressure and the workload on the heart, which improves the cardiac function and reduces the symptoms of heart failure.
Choice D reason: Increasing serum potassium does not improve cardiac performance. In fact, high levels of potassium can cause cardiac arrhythmias and cardiac arrest. Captopril can cause hyperkalemia (high potassium) as a side effect, which is why patients on this drug need to monitor their potassium levels and avoid potassium supplements or salt substitutes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D"]
Explanation
Choice A reason: Starting bolus feedings to stretch the stomach is not recommended for a child with Nissen fundoplication as it can cause increased pressure on the surgical site and lead to complications such as bleeding, perforation, or slippage of the wrap.
Choice B reason: Venting gastrostomy tube is a correct answer as it allows for the release of gas and fluids from the stomach and prevents gastric distension and discomfort. A gastrostomy tube is often placed during Nissen fundoplication to facilitate feeding and venting.
Choice C reason: Keeping child flat in bed to increase absorption of food is not advised for a child with Nissen fundoplication as it can increase the risk of aspiration and pneumonia. The child should be positioned at a 30-degree angle or higher after feeding to prevent reflux.
Choice D reason: Observing for abdominal distension, flushing and hypotension which may indicate dumping syndrome is a correct answer as it is a potential complication of Nissen fundoplication. Dumping syndrome occurs when food moves too quickly from the stomach to the small intestine, causing symptoms such as abdominal cramps, nausea, diarrhea, sweating, and dizziness.
Correct Answer is D
Explanation
Choice A reason: Murmur, tachycardia, and low erythrocyte sedimentation rate are not specific signs of Kawasaki disease. They may indicate other cardiac or inflammatory conditions.
Choice B reason: Abdominal pain, vomiting, and restlessness are not typical signs of Kawasaki disease. They may suggest other gastrointestinal or neurological problems.
Choice C reason: Coarse breath sounds, abnormal ECG, and joint pain are not common signs of Kawasaki disease. They may indicate other respiratory, cardiac, or rheumatic disorders.
Choice D reason: This is the correct choice. Fever, "strawberry tongue" and peeling palms and soles are characteristic signs of Kawasaki disease, which is a rare but serious condition that causes inflammation of the blood vessels. Other signs include red eyes, swollen lips, rash, and swollen lymph nodes.
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