A nurse is planning care for a school-age child diagnosed with type 1 diabetes. Which insulin preparations are either rapid or short acting? (Select all that apply.).

The correct answer is choice B: Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy.

Choice A rationale:

Pulmonic stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy. This choice is incorrect because it includes "aortic hypertrophy" and "left ventricular hypertrophy," which are not components of the tetralogy of Fallot. Aortic hypertrophy is not a recognized structural defect in tetralogy of Fallot, and left ventricular hypertrophy is not a characteristic feature of this congenital heart condition.

Choice B rationale:

Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy. This is the correct choice. Tetralogy of Fallot is characterized by four specific structural defects: pulmonic stenosis (narrowing of the pulmonary valve), ventricular septal defect (hole between the right and left ventricles), overriding aorta (aorta positioned over the ventricular septal defect, receiving blood from both ventricles), and right ventricular hypertrophy (enlargement of the right ventricle due to increased workload).

Choice C rationale:

Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy. This choice is incorrect because it includes "aortic stenosis," which is not part of the tetralogy of Fallot. In tetralogy of Fallot, the stenosis occurs at the pulmonary valve, not the aortic valve.

Choice D rationale:

Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy. This choice is incorrect. While "overriding aorta" is present in tetralogy of Fallot, "atrial septal defect" and "left ventricular hypertrophy" are not part of this condition. Atrial septal defects involve a hole between the two atria, not the ventricles, and left ventricular hypertrophy is not typically seen in tetralogy of Fallot.

The correct answer is choice B. Administer supplemental oxygen before and after suctioning.

Choice A rationale:

Expect symptoms of respiratory distress when suctioning. While respiratory distress can occur during and after suctioning, it is not the main nursing consideration. The primary goal is to minimize any potential complications and ensure the child's safety during the procedure, which can be achieved by following appropriate guidelines.

Choice B rationale:

Administer supplemental oxygen before and after suctioning. Correct Answer. Administering supplemental oxygen before and after suctioning is crucial to maintain adequate oxygenation during and after the procedure. Suctioning can temporarily decrease oxygen levels and cause desaturation, especially in a child who has undergone heart surgery. Providing supplemental oxygen helps prevent hypoxia and supports respiratory function.

Choice C rationale:

Perform suctioning at least every hour. Frequent suctioning at least every hour is not a standard nursing practice, especially for a child who has had heart surgery. Suctioning should only be performed as needed based on the child's clinical condition, and excessive suctioning can irritate the airway and lead to complications.

Choice D rationale:

Suction for no longer than 30 seconds at a time. While limiting the duration of suctioning is important to prevent hypoxia and trauma to the airway, the specific duration of 30 seconds is not a universal rule. Suctioning should be performed for the shortest effective duration to minimize the risk of complications, but the optimal time can vary based on the child's condition and the type of suctioning being used.