Difficulty: Medium
Average Score: 79%
Simulated
Passage / Scenario
A 3-year-old child with congestive heart failure resulting from an underlying congenital heart defect, prescribed digoxin and furosemide.A 3-year-old child with congestive heart failure resulting from an underlying congenital heart defect, is prescribed digoxin and furosemide. Which of the following assessment findings are MOST concerning?
Correct answer
C
Rationale
The correct answer is C: An apical pulse of 70 beats/minute and vomiting. This is concerning because a low heart rate in a child with congestive heart failure may indicate worsening heart function. Vomiting can lead to dehydration, electrolyte imbalances, and potential digoxin toxicity due to decreased absorption.
Rationale for why other choices are incorrect:
A: A blood pressure of 100/56 and a small weight gain may indicate fluid retention but are not as concerning as a low heart rate and vomiting.
B: A heart rate of 150 beats/minute with crying is expected in a distressed child and may not be as concerning as a low heart rate.
D: An hourly urine output of 45mL/hour is within the normal range for a child and may indicate adequate kidney function.
In summary, the combination of a low heart rate and vomiting in a child with congestive heart failure is the most concerning due to potential implications for heart function and medication management
Rationale for why other choices are incorrect:
A: A blood pressure of 100/56 and a small weight gain may indicate fluid retention but are not as concerning as a low heart rate and vomiting.
B: A heart rate of 150 beats/minute with crying is expected in a distressed child and may not be as concerning as a low heart rate.
D: An hourly urine output of 45mL/hour is within the normal range for a child and may indicate adequate kidney function.
In summary, the combination of a low heart rate and vomiting in a child with congestive heart failure is the most concerning due to potential implications for heart function and medication management