An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). The nurse understands dyspnea occurs because blood

Shunted past the pulmonary circulation, causing pulmonary hypoxia

Circulated through the lungs again, causing pulmonary circulatory congestion

Circulated through the ductus from the pulmonary artery to the aorta bypassing the left side of me heart

Shunted past cardiac arteries, causing myocardial hypoxia

Answer and Explanation

The Correct Answer is C

A. Shunted past the pulmonary circulation, causing pulmonary hypoxia: This option is not the primary reason for dyspnea in PDA. While there is shunting, it doesn't directly cause pulmonary hypoxia.

B. Circulated through the lungs again, causing pulmonary circulatory congestion: This option is partially correct but does not address the primary reason for dyspnea, which is the bypassing of the left side of the heart.

C. Circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart.

In patent ductus arteriosus (PDA), a fetal blood vessel called the ductus arteriosus fails to close after birth. This allows oxygenated blood from the left atrium to be shunted directly from the aorta to the pulmonary artery, bypassing the normal route through the left side of the heart and into the systemic circulation. The shunting of oxygenated blood back into the pulmonary circulation can lead to increased pulmonary blood flow and circulatory congestion, causing symptoms such as dyspnea.

D. Shunted past cardiac arteries, causing myocardial hypoxia: PDA primarily affects the pulmonary circulation and left side of the heart, not the coronary arteries. Myocardial hypoxia is not the primary mechanism of dyspnea in PDA.

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Correct Answer is D

Explanation

A. You seem overwhelmed, I'll contact the chaplain to come and talk with you about the options: While offering chaplain support is valuable, it's essential to engage in a conversation with the parents first to understand their needs and concerns.

B. I find it helpful to investigate the options. I will get you a pamphlet about end-of-life care: Providing information is valuable, but in this case, the parents are expressing their emotional distress, and they may need a more empathetic and personalized approach.

C. It's hard to say what the best decision is, but I know the end-of-life team provides wonderful care: While reassuring, this response doesn't actively engage with the parents or explore their feelings and beliefs, which are crucial for making this challenging decision.

D. These decisions are challenging. Tell me about your beliefs and understanding about end-of-life.

This response acknowledges the parents' difficulty with the decision and opens the door for a deeper conversation. It allows the nurse to understand the parents' perspectives, values, and concerns, which is crucial in providing holistic and patient-centered care. This information will help the nurse support the family and guide them through the decision-making process, addressing their specific needs and preferences.

A. Inspect the mouth weekly for ulcerations B. Use a potent commercial mouthwash C. Clean the teeth manually with a soft toothbrush D. Visit a dental professional only during episodes of excessive bleeding or pain

Correct Answer is C

Explanation

A. Inspecting the mouth weekly for ulcerations is not sufficient. Children receiving chemotherapy should be encouraged to perform daily oral care, and any concerning symptoms should be reported promptly to the healthcare provider.

B. Using a potent commercial mouthwash is not recommended, as many commercial mouthwashes contain alcohol or other potentially irritating ingredients. A healthcare provider should recommend a suitable oral rinse if needed.

C. Clean the teeth manually with a soft toothbrush.

Children receiving chemotherapy are at risk of developing mouth sores (mucositis) and other oral complications. It is essential to maintain good oral hygiene to minimize the risk of infection and reduce discomfort. Using a soft toothbrush for gentle manual cleaning is recommended, as it helps to prevent injury to the sensitive oral tissues that can occur with a hard toothbrush.

D. Visiting a dental professional only during episodes of excessive bleeding or pain is not recommended. Regular dental check-ups are important for children receiving chemotherapy to monitor and address oral health issues. Waiting for symptoms of bleeding or pain may result in a delay in addressing potential problems.

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An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). The nurse understands dyspnea occurs because blood

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

The nurse would include in a teaching plan about mouth care for a child receiving chemotherapy to:

Correct Answer is C

Explanation

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