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cv dysfunction
cv deviations (peds)
| Question | Answer |
|---|---|
| changes that occur from fetal circulation | chaanges in hemodynamics, PDA closes, Foramen Ovale closes |
| differences seen in the CV system of an infant/child VS adult | Rate, position of heart, BP |
| Concept to remember when assessing CV function ot the child | least invasive to most invasive |
| defining characteristics of Increased pulmonoary Blood Flow defects | increase amount of blood to the lungs,R ventricular hypertrophy, left to right shunt |
| clinical S/Sx of increased pulmonary blood flow | tachypnea, tachcardia, increase KCAL needs, increase metabolic needs, FTT,poor suck, Na+ and fluid retention |
| Examples of increase pulmonary blood flow defects | PDA,ASD,VSD |
| defining characteristics of disorders of decreased pulmonary blood flow | some obstacle of BF to lungs, pressure in R side increases, right to left shunt, deO2 blood pumped to tissues |
| clinical S/Sx of decreasesd pulmonary blood flow | mild to severe desat, oxygen saturation 50-90%, increase in erythropoietin, polcythemia |
| Examples of defects that result in decrease pulmonary blood flow | tetralogy of Fallot,tricuspid atresia |
| defining characteristics of obstructive disorders | involves some narrowing of a major vessel, causes increase workload of heart, periperal circulation or BF to lungs is affected |
| examples of obsturctive disorders | Ooarctation of Aorta, aortic Stenosis,Pulmonic Stenosis |
| definig characteristics of mixed disorders | complex anomalies that depend on the mising of blood from pulmonary and systemic circulation within the heart for survival |
| Examples of mixed defects | Transposition of Great Vessels, Truncus Arteriosus,Hypoplastic Left Heart Syndrome |
| Acquired Cardiovascular Disorders | disorders due to underlying cardiovascular problems or defects |
| congestive heart failure | inablity of heart to pump adequeate amount of blood to systemic circulation at normal filling pressures to meet body's metabolic demands |
| Causes of CHF | volume overload, pressure overload (from obstructive disorders), decrease contractility (cardiomyopathy), high cardiac output demands |
| Clinical S/Sx of CHF | impaired myocardial function, pulmonary congestion, systemic venous congesiton |
| S/Sx of impaired myocardial function | tachycardia, exercise intolerance, ittirable, poor perfusion, cold extremities, weak pulses, slow cap refill, low BP |
| S/Sx of pulmonary congestion | tachypnea, hypoxemia, imparied gas exchanage, inabiloty to feed, poor weight gain, intercostal retractions, wheezing, increase KCAL needs, FTT,rales |
| S/Sx of systemic congestion | pooling of blood in venous circuation, hepatomegaly, Na+ and fluid retention, weight gain, distended neck veins |
| Management of CHF | improve caridac funciton, remomve accumulataed Na+ and fluid, decrease cardiac demands, improve tissue oxygenation, decrease oxygen consumption |
| ACE inhibitors | inhibits conversion of angiotensin I to II. vasodilation then occurs. renal blood flow increases thus increase diuresis |
| digoxin | increase force of contraction(positive inotropic) decreases heart rate (neg chronotropic) |
| Lasix | diuretic. monitor K+ levels. Fall in K+ enhances effects of digoxin |
| Infective (bacterial) endocarditis | infection of vlaves and inner lining of heart. Sequela of bacteremia in children with congenital anomalies of the heart. areas of risk are those with turbulent BF |
| Clinical S/Sx of endocarditis | new changes in heart sounds, splenomegaly, feeding diffculties, respiratory distress, tachycardia, CHF, splinter hemorrahges, Osler nodes, Janeway spots |
| Management of endocarditis | high dose PCN, PRIMARY PREVENTION IS THE KEY, may use prophylatice antibx 1 hr before invasive proceedure |
| Rheumatic Fever | inflammatory disease that occurs after group Astrep pharyngitis. involves jounts, skin, brain, heart inflamed heomrhagic lessions are formed |
| Management of Rheumatic Fever | eradication of strep infection, prevention of permanent cardiac damage |
| Treatment for Rheumatic Fever | PCN, salicylates, prednisone may be used short term |
| Kawasaki Disease | acute systemic vasculitis of unknown cause. wide spread inflammataion of small and meduim vessels. can lead to aneruysms or infarction |
| clinical S/Sx of Kawasaki disease | high fever, conjunctivae become red, inflammation of pharynx, red/cracked lips, strawbery tongue, rash-may desquamate, VERY ITTITABLE |
| Management of Kawasaki disease | high dose of IVIG, salilcylate therapy, anticoagulatory therapy may be needed |
| Beta Blockers | block Beta receptor sites (decrease HR, dialate blood vessels, increase perfusion to kidneys) |
| Hypertension S/Sx | frequent HA, vertigo, changes in vision, gross behavioral changes |
| Mangement of HTN | dietary practaies and lifestyle changes, evalutae weight, use of salt, aerobic exercise, ACE inhibitors, Beta blockers |
| nursing interventions to promote adequate KCAL supply for infant with cardiovascular dysfunction | group nursing care, allow for periods of rest, encourage small/frequent feedings, use of formula with increase KCAL content |
| PRIMARY PREVENTION to prevent complications of associated with rheumatic fever | completion of antibx for strep throat |
| indomethocin | Prostoglandin inhibitor. Encourages PDA to close |
| Prostoglandin E | Encourages PDA to remain open |
Created by:
NURS390
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