The mother of a 4 week old infant is tearful. She reports the ...

[Frost2351]

The mother of a 4 week old infant is tearful. She reports the physician has told her that her son has a small atrial septal defect. She reports she is worried and asks the nurse more about the condition.
 
  Which statement by the parents best indicates an understanding of the nurse's teaching?
 
  A) This greatly places my son at risk for cardiac failure.
  B) If this does not resolve by the time my child is 1 year old he will likely need surgery.
  C) Most of the time this condition spontaneously resolves.
  D) Since the surgery to correct this condition can be risky my son will need to be at least 40 pounds.

Question 2

The nurse is caring for a child that just returned from a coronary arteriogram in which the catheter was placed through the left femoral artery. Which nursing actions demonstrate knowledge of the procedure? Select all that apply.
 
  A) The nurse allows the patient up to the bathroom only.
  B) The nurse assesses the dorsalis pedis pulse in the left foot.
  C) The nurse assesses the puncture site frequently.
  D) The nurse tells the parents that the physician will discuss the results of the procedure with them.
  E) The nurse assesses the patient's vital signs every 8 hours.

[ricroger]

Answer to Question 1

Ans: C
Atrial septal defects in children most likely resolve without treatment. Those that are not corrected by the age of 18 months will likely require surgical intervention. When planned, surgery is not usually performed until the child is at least 3 years of age. There is no indication other problems are present so the child is not at an increased risk for cardiac failure.

Answer to Question 2

Ans: B, C, D
The nurse must assess the pulse distal to the puncture site to determine that circulation remains adequate to the extremity. Assessing the puncture site ensures early recognition of bleeding from the site. The physician will be able to inform the parents regarding the results of the procedure after completion. The child should be kept on bedrest for a specified period of time, so they cannot be up to the bathroom. Vital signs will need to be taken more frequently than every 8 hours for early detection of complications.