A 4-day-old infant presents to the emergency department. Parents statethat the infant has been breat

A 4-day-old infant presents to the emergency department. Parents statethat the infant has been breathing fast, sweating, and feeding poorly since discharge from the hospital following a normal vaginal delivery.Upon assessment, vital signs are obtained with the following results:•  Temperature (axillary): 36.7°C•  Heart rate: 160 beats per minute with a murmur•  Respiratory rate: 70 breaths per minute•  SpO2: 95% on room air.•  Breath sounds: Clear to auscultation•  Chest radiograph, which shows cardiomegaly and increased vascular markings 1. In order to assess this patient, what should the respiratory therapist do first?a. Recommend obtaining electrolytesb. Perform a physical assessmentc. Recommend obtaining a complete blood countd. Recommend an ECG 2. Based on the examination findings, which two steps should the respiratory therapist recommend?i. Echocardiogramii. Blood pressure measurements in all four extremitiesiii. Pre- and postductal oxygen saturationiv. Palpating upper and lower extremity pulsesa. i and iiib. ii and ivc. i and iid. iii and iv 3. The diagnosis of patent ductus arteriosus is made by echocardiogram. Which of the following are the treatment options?a. Pericardial patchb. Surgical ligationc. Administration of beta blockersd. Inhalation of nitric oxide   Case Study 2A 10-day-old infant presents to the emergency department. Parents state that the infant has been very pale, irritable, poorly feeding, tachypneic for the last week, and lethargic for the last 24 hours.Upon assessment, vital signs are obtained with the following results:•  Temperature (axillary): 36.7°C•  Heart rate: 160 beats per minute•  Respiratory rate: 65 breaths per minute•  Blood pressure: 110/65 mm Hg•  SpO2: 95% on room air•  Breath sounds: Clear to auscultationPhysical examination findings include strong pulses and hypertension in the upper extremities, diminished pedal pulses, and a blood pressure gradient, with low or unreadable blood pressures in the lower extremities. A systolic murmur is present at the upper left sternal border. An apical systolic ejection “click” is present. The physician orders an ECG.The results of the diagnostic tests are as follows:•  Chest X-ray shows a normal or enlarged heart.•  ECG shows right ventricular hypertrophy.•  ECHO shows a narrowing in the aorta.A diagnosis of severe coarctation is made, and the infant is admitted to the intensive care unit.1. In order to assess this patient, what should the clinician obtain?a. Electrolytesb. Physical assessmentc. Complete blood countd. MRI of the chest 3. What interventions and/or additional testing should the clinician now consider?i. Cardiac catheterizationii. Echocardiogramiii. Doppler study of the legsiv. Chest radiographa. i and ivb. ii and iiic. i and iid. iii and iv4. Upon admission to the cardiac intensive care unit, what is the first medical intervention that should be performed?a. Initiation of inhaled nitric oxideb. Administration of a fluid bolusc. Infusion of prostaglandin Ed. Intubation and mechanical ventilation 5. Corrective actions for coarctation of the aorta include surgery to remove the narrowed area, balloon dilation during cardiac catheterization, and which of the following?i. A patch aortoplastyii. Ligation of the ductus arteriosusiii. Graft to bypass the coarctationiv. Performing a Fontan procedurea. i and iib. ii and ivc. i and iiid. iii and iv Health Science Science Nursing SCIENCE / RSPT Share QuestionEmailCopy link Comments (0)

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