A nurse is collecting data from an infant who has a large patent ductus arteriosus. Which of the following is clinical manifestations should the nurse expect?

Cyanosis with crying

Weak pulses

Chronic hypoxemia

Machine-like murmur

Answer and Explanation

The Correct Answer is D

A. Cyanosis with crying: Cyanosis is less common in isolated PDA and more indicative of other congenital heart defects. PDA usually results in increased pulmonary blood flow and may not directly cause cyanosis, especially in less severe cases.

B. Weak pulses: PDA typically causes increased pulmonary blood flow and can result in bounding pulses rather than weak ones. Weak pulses are more indicative of reduced cardiac output, which is not characteristic of PDA.

C. Chronic hypoxemia: Chronic hypoxemia is less associated with PDA and more common in cyanotic heart defects where oxygenated and deoxygenated blood mix. PDA primarily affects the volume of blood flow to the lungs and may not lead to hypoxemia unless complicated by other conditions.

D. Machine-like murmur: A characteristic feature of PDA is a continuous, machine-like murmur caused by turbulent blood flow between the aorta and the pulmonary artery. This murmur is a hallmark sign of PDA and is typically heard during auscultation.

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Correct Answer is C

Explanation

A. "He takes his medication between meals with water." Taking carbamazepine with food helps reduce gastrointestinal upset, but taking it between meals is not critical unless there are specific issues. This is not a priority unless the patient is experiencing significant GI discomfort.

B. "He only sleeps about 5 hours each night." Insufficient sleep can exacerbate seizure disorders, but it is not directly life-threatening. Improving sleep hygiene is important but not the most immediate concern compared to other symptoms.

C. "He seems to be getting a lot more bumps and bruises lately." Increased bruising can indicate thrombocytopenia, a potential side effect of carbamazepine, which can lead to serious bleeding issues. This is the priority as it may indicate a severe adverse effect requiring immediate medical attention and possible adjustment of medication.

D. "He has not been eating as much lately." Decreased appetite can be a side effect of many medications, including carbamazepine, but it is generally not immediately dangerous unless it leads to significant weight loss or nutritional deficiencies. It’s important but not the most urgent concern.

A. "This will not be painful, just a little uncomfortable." B. "Let's play a game of blowing cotton balls across your table." C. "Do you want to take deep breaths for me now?" D. "You can't go to the playroom until you finish doing your deep breathing."

Correct Answer is B

Explanation

A. "This will not be painful, just a little uncomfortable." While this statement might provide some reassurance, it does not actively engage the child or make the task of taking deep breaths more enjoyable.

B. "Let's play a game of blowing cotton balls across your table." This is the best choice as it makes deep breathing fun and engaging for the child, encouraging them to participate without feeling like it’s a chore.

C. "Do you want to take deep breaths for me now?" This approach is too passive and doesn't engage the child actively or make the activity interesting.

D. "You can't go to the playroom until you finish doing your deep breathing." This approach can create negative reinforcement and might make the child associate deep breathing with punishment or coercion, which is not desirable.

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A nurse is collecting data from an infant who has a large patent ductus arteriosus. Which of the following is clinical manifestations should the nurse expect?

Nursing Test Bank

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Explanation

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