A nurse is caring for an infant who has coarctation of the aorta. Which of the following should the nurse identify as an expected finding?

Frequent nosebleeds

Increased intracranial pressure

Upper extremity hypotension

Weak femoral pulses

Answer and Explanation

The Correct Answer is D

A. Frequent nosebleeds: While hypertension can occur in coarctation of the aorta, frequent nosebleeds are not a typical finding associated with this condition.

B. Increased intracranial pressure: This is not a direct finding of coarctation of the aorta. Increased intracranial pressure may be related to other conditions, but it is not specifically expected in this context.

C. Upper extremity hypotension: In coarctation of the aorta, the upper extremities usually experience higher blood pressure due to the narrowing of the aorta distal to the branches supplying the arms. Therefore, hypotension in the upper extremities is not expected.

D. Weak femoral pulses: This is an expected finding in coarctation of the aorta, as the narrowing of the aorta can lead to decreased blood flow to the lower body, resulting in weak or diminished femoral pulses compared to the upper extremities.

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Correct Answer is C

Explanation

A) Administer sedation for the procedure: The administration of sedation is typically the responsibility of an anaesthesiologist or a provider. While some procedures may require sedation, the nurse does not initiate this without an order, making this option less appropriate.

B) Schedule an MRI post procedure to verify placement: MRI is not a standard method for verifying the placement of a peripherally inserted central catheter (PICC). Instead, a chest X-ray is usually performed to confirm correct placement in the superior vena cava, making this option inappropriate.

C) Measure the arm circumference above the insertion site daily: This intervention is appropriate as it helps monitor for complications such as swelling or thrombosis. Measuring the circumference can provide important information about the vascular status of the limb and any potential complications related to the catheter.

D) Use gauze to secure an arm board to the involved extremity: While stabilization of the arm may be necessary, gauze is not typically used to secure an arm board. Instead, secure devices or appropriate taping techniques are preferred. This option may not be the most effective or appropriate method for stabilization.

A. Apply petroleum jelly to soothe the mucous membranes. B. Clean the equipment with an alcohol-based cleaning product. C. Avoid using nail polish remover around the client. D. Use synthetic fabrics for the client's bedding.

Correct Answer is C

Explanation

A) Apply petroleum jelly to soothe the mucous membranes: This is not advisable, as petroleum jelly is flammable and can pose a risk when using oxygen. Instead, a water-based lubricant is safer for mucous membranes.

B) Clean the equipment with an alcohol-based cleaning product: Alcohol is flammable and not recommended for cleaning oxygen equipment. Mild soap and water are more suitable for maintaining cleanliness.

C) Avoid using nail polish remover around the client: This is the correct answer. Nail polish remover often contains acetone, which is flammable and should be avoided in environments where oxygen is in use to prevent fire hazards.

D) Use synthetic fabrics for the client's bedding: This is incorrect. Natural fabrics like cotton are preferred because synthetic fabrics can create static electricity, increasing the risk of fire in the presence of oxygen.

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A nurse is caring for an infant who has coarctation of the aorta. Which of the following should the nurse identify as an expected finding?

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