1330 Cardiac catheterization performed; ventricular septal defect closed with mesh Admit to the pediatric floor for observation Check pedal pulses every 4 hours Nothing by mouth Place the child on a continuous cardiopulmonary monitor The nurse reviews the post-catheterization orders. What two orders would the nurse question?

B. Check pedal pulses every 4 hours: This order should be questioned because after a ventricular septal defect closure, it is essential to assess and monitor peripheral pulses frequently, especially in the immediate post-catheterization period. Checking pedal pulses every 4 hours may not provide adequate monitoring and could potentially lead to delayed detection of complications. C. Give lactated Ringers intravenously at 66 ml/hr while NPO: This order should be questioned because it specifies a continuous intravenous infusion of lactated Ringer's solution, but the patient is listed as "Nothing by mouth" (E). In cases where a patient is NPO, it's important to clarify the rationale for the intravenous fluid rate and consider whether it's appropriate, especially after a cardiac catheterization procedure. The other orders are appropriate or necessary for the post-catheterization care of a child with a closed ventricular septal defect: A. Point of care blood glucose: Monitoring blood glucose levels is relevant in post-catheterization care. D. Vital signs every 4 hours: Monitoring vital signs is standard post-catheterization care. F. Admit to the pediatric floor for observation: This order is appropriate for post-catheterization observation. G. Check dressing every 15 minutes for 1 hour and then every hour: Frequent dressing checks are important for assessing and preventing bleeding or other complications at the catheterization site. H. Place the child on a continuous cardiopulmonary monitor: Continuous monitoring is important for early detection of any cardiopulmonary issues in the post-catheterization period. In summary, monitoring peripheral pulses and the appropriateness of intravenous fluids in relation to NPO status should be questioned in this context.