A nurse is assessing a 7-day-old infant. The nurse detects a soft ...

[Jramos095]

A nurse is assessing a 7-day-old infant. The nurse detects a soft murmur. The nurse notifies the primary care physician because the nurse is aware that fetal shunts are closed in the infant at what point in time?
 
  a. When the umbilical cord is cut
  b. Within several days of birth
  c. Within a month after birth
  d. By the end of the first year of life

Question 2

A child had a ventricular septal defect surgically repaired 3 months ago. Which antibiotic prophylaxis is indicated for an upcoming dental procedure?
 
  a. No antibiotic prophylaxis is necessary.
  b. Amoxicillin is taken orally 1 hour before the procedure.
  c. Oral penicillin is given for 7 to 10 days before the procedure.
  d. Parenteral antibiotics are administered for 4 to 8 weeks after the procedure.

[krakiolit]

Answer to Question 1

B
In the normal neonate, fetal shunts functionally close in response to pressure changes in the systemic and pulmonary circulations and to increased oxygen content. This process may take several days to complete. With the neonate's first breath, gas exchange is transferred from the placenta to the lungs. The separation of the fetus from the umbilical cord does not contribute to the establishment of neonatal circulation.

Answer to Question 2

B
The standard prophylactic agent is amoxicillin given orally 1 hour before the procedure. Antibiotic prophylaxis is indicated for the first 6 months after surgical repair. Antibiotic prophylaxis is not given for this period of time. The treatment for infective endocarditis involves parenteral antibiotics for 4 to 8 weeks.