A pediatric nurse is assessing a newborn diagnosed with ...

[vicky]

A pediatric nurse is assessing a newborn diagnosed with persistent patency of the ductus arteriosus. Which of the following findings are associated with this heart defect? Select all that apply.
 
  A)
  Murmur heard at the second intercostal space, during both systole and diastole
  B)
  BP 84/30 classified as a wide pulse pressure
  C)
  Shortness of breath with activity such as kicking
  D)
  Stridor with inspiratory wheezes
  E)
  Bulging jugular neck veins

Question 2

Which of the following situations related to transition from fetal to perinatal circulation would be most likely to necessitate medical intervention?
 
  A)
  Pressure in pulmonary circulation and the right side of the infant's heart fall markedly.
  B)
  Alveolar oxygen tension increases causing reversal of pulmonary vasoconstriction of the fetal arteries.
  C)
  Systemic vascular resistance and left ventricular pressure are both increasing.
  D)
  Pulmonary vascular resistance, related to muscle regression in the pulmonary arteries, rises over the course of the infant's first week.

[otokexnaru]

Answer to Question 1

Ans:
A, B

Feedback:

Persistent patency of the ductus arteriosus is defined as a duct that remains open for greater than 3 months. A murmur is detected within days of birth. It is loudest at the second left intercostal space and is continuous through systole and diastole. A wide pulse pressure is common (BP 84/30). Most newborns have an elevated respiratory rate with exertional activity. Stridor is usually associated with bronchial infections or narrowing of the airways. Bulging jugular neck veins are associated with right-sided heart failure.

Answer to Question 2

Ans:
D

Feedback:

One of the hallmarks of the transition from placental circulation is a rapid and then steady decrease in pulmonary vascular resistance. Answers A, B, and C relate normal physiological processes.

[vicky]

Excellent

[softEldritch]

TYSM