What is the nurse's first action when planning to teach the parents of an infant with a congenital heart defect (CHD)?

Choice A rationale:

Ask her to turn to one side. The supine position during labor can compress the vena cava, reducing blood flow to the uterus and potentially compromising fetal oxygenation. Turning the woman to her side, especially the left side, can relieve this pressure and improve blood flow to the uterus, ensuring adequate oxygen supply to the fetus. This position change is crucial for the well-being of both the mother and the baby during labor.

Choice B rationale:

Elevate her feet and legs. Elevating the woman's feet and legs might not be effective in relieving the pressure on the vena cava, as it does not change the orientation of the uterus in relation to the vena cava. Turning the woman to her side is a more appropriate and effective action to improve blood flow to the uterus and fetus.

Choice C rationale:

Take her blood pressure. While monitoring the woman's blood pressure is essential during labor, it is not the most appropriate action in this situation. The priority is to relieve the compression of the vena cava by changing the woman's position.

Choice D rationale:

Determine whether fetal tachycardia is present. Monitoring the fetal heart rate is crucial during labor, but the woman's position should be the immediate concern if she is lying in the supine position. Changing her position to relieve the vena cava compression takes precedence to ensure adequate oxygenation to the fetus.

Choice A rationale:
The child's fever in Kawasaki disease is typically unresponsive to antibiotics. The disease primarily affects blood vessels and can lead to the development of coronary artery aneurysms. Antibiotics are not the mainstay of treatment for Kawasaki disease.
Choice B rationale:
Kawasaki disease does not primarily involve the joints. It is a systemic vasculitis that affects medium-sized arteries throughout the body, including the coronary arteries. Joint involvement is not a characteristic feature of this condition.
Choice C rationale:
Aspirin is actually a crucial part of the treatment for Kawasaki disease. High-dose aspirin therapy (80-100 mg/kg/day) is administered until the child is afebrile, then the dose is reduced and continued for several weeks to prevent blood clots and inflammation in the coronary arteries.
Choice D rationale:
This is the correct answer. The therapeutic management of Kawasaki disease includes the administration of intravenous immunoglobulin (IVIG) and aspirin. IVIG helps reduce inflammation and prevent coronary artery abnormalities, while high-dose aspirin is used for its anti-inflammatory and antiplatelet effects. This combination of treatments has been shown to be effective in reducing the risk of coronary artery complications associated with Kawasaki disease.