A nurse is collecting data from an infant a large patent ductus arteriosus. Which of the following is clinical manifestations should the nurse expect?
Machine like murmur
Chronic hypoxemia
Cyanosis with crying
Weak pulse
The Correct Answer is A
A. Machine-like murmur.
This option is correct. A characteristic clinical manifestation of a large patent ductus arteriosus is a continuous "machine-like" murmur heard on auscultation. This murmur is typically heard best at the upper left sternal border and may radiate to the back.
B. Chronic hypoxemia.
Chronic hypoxemia is not typically a primary manifestation of a large PDA. While PDA can lead to increased pulmonary blood flow and potentially contribute to pulmonary congestion, chronic hypoxemia may not be a prominent feature unless complications such as heart failure develop.
C. Cyanosis with crying.
Cyanosis with crying is more commonly associated with cyanotic congenital heart defects such as tetralogy of Fallot. While PDA can contribute to cyanosis in certain circumstances, it is not typically a consistent clinical manifestation.
D. Weak pulse.
A weak pulse is not typically associated specifically with a large PDA. Infants with PDA may have bounding pulses due to increased blood flow through the ductus arteriosus.
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Related Questions
Correct Answer is B
Explanation
A. Drooling:
Drooling can occur post-tonsillectomy due to throat discomfort or swelling. However, it is not specific to hemorrhage. It may result from pain, swelling, or difficulty swallowing.
B. Continuous swallowing:
Continuous swallowing is indeed a clinical manifestation of hemorrhage after a tonsillectomy. The presence of blood in the throat triggers the swallowing reflex, leading to frequent swallowing by the patient. This symptom is characteristic of hemorrhage and requires immediate medical attention.
C. Poor fluid intake:
Poor fluid intake can occur post-tonsillectomy due to pain, discomfort, or nausea. While it can be a concern for overall recovery, it is not specific to hemorrhage.
D. Increased pain:
Increased pain can be associated with hemorrhage, especially if it is sudden, severe, or worsening. However, it is not as specific as continuous swallowing in indicating hemorrhage post-tonsillectomy. Increased pain can also be due to various other reasons such as inflammation, infection, or trauma.
Correct Answer is C
Explanation
A. A room with a toddler who has pneumonia.
This option is not ideal because both RSV and pneumonia are respiratory infections that can spread to other patients. Placing these two patients together could increase the risk of cross-infection.
B. A private room with reverse isolation.
Reverse isolation is typically used to protect immunocompromised patients from acquiring infections from others. However, in the case of RSV, reverse isolation is not necessary because RSV primarily affects infants and young children who are generally not immunocompromised. Therefore, this option is not appropriate for an infant with RSV.
C. A private room with contact/droplet precautions.
This option is the most appropriate. RSV is primarily spread through respiratory droplets and direct contact with respiratory secretions. Placing the infant in a private room with contact/droplet precautions helps to minimize the risk of transmission to other patients. Healthcare workers and visitors entering the room should adhere to appropriate precautions, including wearing personal protective equipment (PPE) such as masks, gloves, and gowns.
D. A room with an infant who has croup.
Placing an infant with RSV in the same room as an infant with croup is not ideal because both conditions involve respiratory symptoms and may increase the risk of cross-infection.
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