A nurse is assessing a 3-year-old client who has been diagnosed with an Atrial Septal Defect (ASD). Which of the following findings should the nurse expect? (Select All That Apply)

Right Atrial Enlargement

Left Atrial Enlargement

Shortness of breath.

Pulmonary hypertension

Pulmonary hypotension

Answer and Explanation

Correct Answer : A,C,D

A.   Right atrial enlargement occurs due to the increased blood flow from left to right shunting, which can cause volume overload in the right atrium.
B.   Left atrial enlargement is typically seen in conditions that cause increased left atrial pressure, such as mitral valve disease or left-sided heart failure, not in ASD.
C.   Shortness of breath is a common symptom due to increased blood flow to the lungs, which can lead to pulmonary congestion.
D.   Pulmonary hypertension may develop over time due to increased blood flow and pressure in the pulmonary circulation from the left-to-right shunting of blood.
E.   Pulmonary hypotension is not associated with ASD. The condition typically leads to increased pressure in the pulmonary arteries, not decreased pressure

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Correct Answer is A

Explanation

A. Increased somnolence or lethargy is a common sign of increased intracranial pressure in infants.
B. Increased heart rate may initially occur but can later slow down as intracranial pressure rises, leading to bradycardia.
C. Depressed fontanels are indicative of dehydration, not increased intracranial pressure. Bulging fontanels are more indicative of increased intracranial pressure.
D. Brisk pupillary reaction to light is normal; a sluggish or absent reaction could indicate increased intracranial pressure.

A. Initiate isolation protocols. B. Administer IV antibiotics. C. Prepare for a lumbar puncture. D. Obtain blood cultures.

Correct Answer is A

Explanation

A. Bacterial meningitis is highly contagious, and isolation precautions are necessary to prevent the spread of the infection to others. This should be the nurse's first action to protect both the child and others.
B. While antibiotics are crucial in treating bacterial meningitis, initiating isolation protocols is the first priority to prevent transmission to others.
C. A lumbar puncture is needed to confirm the diagnosis of meningitis, but isolation protocols should be established first to prevent spread.
D. Blood cultures are important for diagnosing bacterial meningitis but are secondary to ensuring proper isolation to prevent contagion.

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A nurse is assessing a 3-year-old client who has been diagnosed with an Atrial Septal Defect (ASD). Which of the following findings should the nurse expect? (Select All That Apply)

Nursing Test Bank

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