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Diagnostic Evaluation

- The diagnosis of CHD is based on a combination of history, physical examination, chest Xray, electrocardiogram (ECG), echocardiogram (ECHO), cardiac catheterization, and other tests as indicated

- History: The nurse should obtain information about the prenatal history, family history of CHD or genetic syndromes, maternal infections or illnesses during pregnancy, exposure to drugs or toxins during pregnancy, onset, and duration of symptoms, feeding difficulties, growth patterns, activity tolerance, and medications

- Physical examination: The nurse should assess for signs of heart failure and hypoxia, such as heart rate and rhythm, blood pressure and pulses in all extremities, respiratory rate and effort, oxygen saturation, skin color and temperature, edema, liver size, weight and height percentiles, and developmental milestones

- Chest Xray: This test can show the size and shape of the heart and lungs, and detect any abnormalities such as cardiomegaly or pulmonary edema

- ECG: This test can measure the electrical activity of the heart and detect any arrhythmias or conduction problems

- ECHO: This test uses ultrasound waves to create images of the heart and its structures. It can show the size and function of the chambers and valves, the direction and magnitude of blood flow, and the presence and location of any defects

- Cardiac catheterization: This is an invasive procedure where a catheter is inserted into a blood vessel (usually in the groin) and advanced to the heart. It can measure pressures and oxygen levels in different parts of the heart and vessels, inject contrast dye to visualize any defects or obstructions and perform interventions such as closing defects or dilating stenotic valves

Questions on Diagnostic Evaluation

Correct Answer is ["A"]

Explanation

<p>This statement is true, as treatment options for congenital heart diseases often include medications, surgical interventions, or other medical therapies, depending on the specific condition and its severity.</p>

Correct Answer is D

Explanation

Correct answer. Neonates and infants are the highest-risk population for congenital heart diseases because these conditions are typically present from birth and may become apparent shortly after delivery or during infancy.

Correct Answer is C

Explanation

This option is incorrect. Congenital heart diseases do not typically present with mild cold-like symptoms and fever. These are more indicative of common respiratory infections, unrelated to heart conditions.

Correct Answer is C

Explanation

This option is incorrect. While early treatment can significantly improve life expectancy and overall health outcomes, it may not guarantee a "normal" life expectancy for all individuals with congenital heart diseases, as outcomes depend on the specific condition and severity.

Correct Answer is A

Explanation

This option is incorrect. Vaccination is important for preventing certain infections, but it is not directly related to the cause or prevention of congenital heart diseases.

Correct Answer is A

Explanation

This option is incorrect. Prenatal care involves monitoring the health and development of the fetus and aims to address potential issues to ensure a healthy pregnancy and baby, including the early detection and management of congenital heart diseases.

Correct Answer is A

Explanation

This option is incorrect. There are known risk factors for congenital heart diseases, as mentioned in option A. While some cases may occur sporadically without identifiable risk factors, many cases have associated factors that can be addressed through prenatal care and management.Questions

Correct Answer is B

Explanation

This option is incorrect. While genetic factors play a significant role in the etiology of congenital heart diseases, there are other identifiable risk factors, as mentioned in option B.

Correct Answer is C

Explanation

This option is incorrect. While a family history of congenital heart diseases may increase the risk, seeking appropriate medical guidance and prenatal care can help manage and address these risks.

Correct Answer is A

Explanation

This option is incorrect. Iron deficiency anemia can affect maternal and fetal health, but it is not considered a risk factor for congenital heart diseases.

Correct Answer is B

Explanation

This option is incorrect. Medication use during pregnancy can have various effects on the developing baby, and certain medications may increase the risk of congenital heart diseases.

Correct Answer is A

Explanation

This option is incorrect. Employment and work-related stress levels are not known risk factors for congenital heart diseases.

Correct Answer is C

Explanation

This option is incorrect. Genetic inheritance is a non-modifiable risk factor for congenital heart diseases, as it relates to the transmission of genes from parents to their children.

Correct Answer is B

Explanation

This option is incorrect. Alcohol consumption during pregnancy can have far-reaching effects on fetal development, affecting both the heart and brain, among other organ systems.QUESTIONS

Correct Answer is B

Explanation

<p>This option is incorrect. Excessive weight gain and a rapid growth rate are not typical early symptoms of congenital heart diseases.</p>

Correct Answer is C

Explanation

<p>This option is incorrect. Congenital heart diseases can significantly impact feeding patterns in infants, and special attention is required to support their nutritional needs.</p>

Correct Answer is D

Explanation

Correct answer. Excessive sweating during feedings can be a sign of increased cardiac effort and inadequate oxygen supply in some congenital heart diseases. This symptom may be present in babies with cyanotic heart defects, where oxygen-rich blood is not adequately circulated to the body, leading to compensatory mechanisms like sweating to maintain oxygen balance.

Correct Answer is A

Explanation

This option is incorrect. Frequent episodes of irritability and excessive crying may be present in infants with heart defects, but they are not specific to heart failure in toddlers.

Correct Answer is C

Explanation

This option is incorrect. Clubbing of the fingers and toes is not commonly observed during adolescence, and it is not temporary. It can persist if the underlying heart condition is not adequately managed.

Correct Answer is C

Explanation

This option is incorrect. Heart murmurs that are harsh, loud, and continuous are not considered benign and require further evaluation and monitoring.

<p>This option is incorrect. Resolution of cyanosis and pink coloration of the lips and nail beds are positive signs of improved oxygenation and may indicate effective management of the heart defect but not the potential worsening of heart failure.</p>

Incorrect. Weight gain following the growth chart percentile for age is not directly associated with congenital heart diseases. There are more specific clinical indicators to consider in the assessment of this condition.

Incorrect. Mild nausea can be a common side effect of digoxin, and the client should not discontinue the medication without consulting their healthcare provider. Instead, they should report any adverse effects for proper evaluation.

Incorrect. A heart murmur audible throughout systole and diastole can indicate structural heart abnormalities. While it requires medical follow-up, it may not need immediate intervention unless accompanied by other concerning symptoms.

Incorrect. Aspirin is an anticoagulant, and the client should consult their healthcare provider about the management of aspirin therapy before any surgical procedure.

Incorrect. Prostaglandin E1 does not promote the growth of cardiac muscle tissue. Its primary therapeutic effect is related to the patency of the ductus arteriosus.

Incorrect. Elevating the head of the bed can help with respiratory effort, but it is not the priority intervention. Monitoring urine output and fluid balance is more critical in the early postoperative period.

Incorrect. Activities with prolonged standing may increase venous return and potentially worsen certain congenital heart conditions. The focus should be on low to moderate intensity exercises.QUESTIONS

Incorrect. Mild swelling of the ankles after activity is not directly related to digoxin use. The nurse should monitor the client's ankles for any worsening swelling, but it does not require immediate reporting unless accompanied by other concerning symptoms.The answer is A

Incorrect. Foods high in vitamin B12 are not contraindicated with enalapril use. There is no specific dietary restriction regarding vitamin B12 intake for clients taking this medication.

Incorrect. All surgical procedures carry some risk of infection. While healthcare providers take measures to minimize this risk, it is not accurate to claim there is no risk at all.

Incorrect. Peripheral vascular disease primarily affects the arteries and veins in the extremities and is not directly related to cyanosis and clubbing of the fingers.

Incorrect. Determining the child's weight is relevant in assessing the effectiveness of furosemide therapy. However, it is not the priority action before administering the medication. Respiratory assessment is more critical for immediate intervention.Questions

The answer is D. Clients with congenital heart diseases are at increased risk of infections, so it is essential to educate the client about infection prevention measures, such as limiting contact with other children during times of increased risk.

Incorrect. The nurse, along with the healthcare provider, should determine the medication dosing times based on the infant's condition and the prescribed schedule. Leaving the decision solely to the parents may lead to dosing errors or missed doses.

The answer is D. Shortness of breath and chest pain can be signs of a cardiac event or worsening of the congenital heart disease. The client should seek medical attention immediately to receive appropriate evaluation and treatment.

Incorrect. While observing for respiratory distress is crucial, it is not the priority action in this specific scenario of preparing to administer digoxin. Checking the heart rate takes precedence.

Incorrect. Limiting fluid intake may not be necessary unless specifically advised by the healthcare provider. Infants need sufficient hydration, and fluid intake should be managed based on the infant's overall health and condition.

Incorrect. Most congenital heart diseases cannot be "cured" with diagnostic testing alone. However, the information obtained from the tests is crucial in determining the most appropriate management and treatment options.Questions

<p>Incorrect. Prostaglandin E1 does not decrease heart rate. It primarily affects the patency of the ductus arteriosus.</p>
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