In a physical assessment of an infant with a ventricular septal defect (VSD), the nurse notices dyspnea, hepatosplenomegaly, and periorbital edema and understands that these are clinical manifestations of:

• Heart failure

• Endocarditis

• Dehydration

• Decreased central venous pressure

Which nursing intervention is not appropriate when caring for an infant with cardiovascular alterations?

• Discouraging breastfeeding

• Limiting bottle feedings to no longer than 30 minutes

• Maintaining a neutral thermal environment

• Providing periods of uninterrupted rest

An infant with a left-to-right shunt is admitted to the hospital for congestive heart failure. Yesterday, she weighed 3.6 kg. A finding that indicates a worsening of her condition today is: (Select all that apply)

• Weight of 3.72 kg

• Urine output of 40 mL in the past 12 hours

• Crackles in the lower lobes

• Consuming a full bottle without respiratory distress

• Peripheral edema

While the nurse is performing a newborn assessment, he finds that the infant’s blood pressure in her arms is much higher than in her legs. The nurse suspects that the infant has:

• Aortic stenosis

• Atrioventricular canal

• Coarctation of the aorta

• Truncus arteriosus

1. While the nurse is taking routine vital signs, she notices that the infant is having a hypercyanotic episode. What should the nurse do first?

• Continue getting vital signs for a baseline comparison

• Place the infant in a knee-chest position

• Get a pulse oximetry reading

• Administer morphine sulfate

The father of a child with a congenital heart defect asks the nurse why his daughter has to take penicillin before she gets her teeth cleaned by the dentist. The nurse explains that this is necessary to prevent:

• Infective endocarditis

• Congestive heart failure

• Rheumatic fever

• Infected gums

A pediatrician has prescribed oxygen as needed for an infant with an acyanotic heart defect. In which situation should the nurse administer the oxygen to the infant?

• During sleep

• When changing the infant's diaper

• When the mother is hold the infant

• When drawing blood for electrolyte level testing

An infant who has a congenital heart defect comes into the clinic with irritability, pallor, and increased cyanosis that began quickly over the last 30 minutes. As the nurse assesses the infant, the parent asks why the child's color is bluish. The best response by the nurse is, "The baby's skin color is:

• caused by a left-to-right shunting of blood."

• association with liver dysfunction secondary to congestive heart failure."

• related to hemoglobin level and oxygen saturation."

• due to poor iron levels in your child's body."

Which physiological changes occur as a result of hypoxemia in congestive heart failure?

• polycythemia and clubbing

• anemia and barrel chest

• increased white blood cells and low platelets

• elevated erythrocyte sedimentation rate and peripheral edema

Which interventions decrease cardiac demands in an infant with congestive heart failure? (Select all that apply)

• Allow parents to hold and rock their child

• Feed only when the infant is crying

• Keep the child uncovered to promote low body temperature

• Feed the child when sucking the fists

• Cluster nursing activities