Peds-cardiac, developmental, dehydration
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| show | HR-120-160 beats/min; RR-23-50 resp/min; BP-110/71 mmHg
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| What is the normal weight gain for an infant? normal height increased? | show 🗑
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| show | Lose moro and babinski reflex around 4-5 mths. Lose sucking reflex around 12 mths-recommended to ween from bottle at this time
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| When does the posterior fontanel close? anterior fontanel? | show 🗑
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| What are the normal VS for a toddler (13-36 mths) | show 🗑
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| show | 3 inches per year.
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| show | By 13-15 mths-walks independently; by 18 mths-stacks 3-4 blocks; by 24 mths-stacks 5 or more blocks; by 36-stacks 9-10 blocks.
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| show | By 15 mths-recognizes pictures in books; By 18 mths-Points to body parts; 30 mths-gives first and last name; by 36 mths-speaks 2-3 word phrases & names figures in a picture.
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| show | Erikson-autonomy vs shame & doubt; Piaget-Sensorimotor/Preoperational; Freud-Anal phase
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| show | 24-36 months.
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| show | Negativism "No-No"; Temper tantrums; separation anxiety; have a concept of time.
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| show | 15mths- feeds self with cup, uses spoon; 24 mths-feeds self well; 36 mths- pours from pitcher.
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| How do toddlers play? | show 🗑
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| What are the suggested toys for a toddler? | show 🗑
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| show | HR: 65-110; RR: 20-25; BP: 110/75
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| show | 4-6 lbs/year
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| Body Proportions for preschooler: | show 🗑
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| What is the gross motor development for preschoolers and when? | show 🗑
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| show | 48 mths-nonsense words, repeats what he hears
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| show | around age 5
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| What are the psychosocial stages for preschoolers? | show 🗑
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| show | Imaginative/fantasy; questions everything; cooperative
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| show | cooperative play. Imitative and imaginary
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| show | HR 60-95; RR 14-22; BP 120/75
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| show | Erikson-Industry vs Inferiority; Piaget-Concrete operations; Freud-Latency
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| Characteristics for 10-12 years old | show 🗑
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| What foods do you avoid in infancy? | show 🗑
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| show | children do not have the enzyme to break down phenylalanine. Phenylalanine is in protein so it leads to build up in body.
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| show | mental retardation, seizures, skin rashes. Reduce protein in diet.
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| show | if under 7- at the 4th intercostal space. If over 7- at 5th intercostal space
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| show | not growing like they should, length/weight is not increasing. Growth chart doesn't curve, but plateaus. They are disinterested, poor eye contact, irritable. They stop meeting developmental milestones (walking, talking, etc)
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| What are your top 2 worries with a heart anomaly? | show 🗑
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| show | Usually within first year of life. It is the 2nd leading cause of death in the first year of life.
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| What are some prenatal factors linked to congenital heart disease? | show 🗑
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| show | if sibling or parent has CHD; child with chromosomal abnormalities (Down's) tend to have CHD too.
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| How is CHD diagnosed? | show 🗑
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| show | Consent, assess for allergy to shellfish or iodine dye
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| what is post-procedure care for cardiac cath? | show 🗑
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| What are the s/s of CHD in an infant? in children? | show 🗑
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| What are s/s of peripheral edema? | show 🗑
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| show | VSD, ASD, PDA. Left to right shunting occurs, so you have extra blood going to lungs because oxygenated blood flows into R ventricle which is full of deoxygenated blood, then pumped to lungs.
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| show | Ventricular septal defect- an abnormal opening in the septum separating the R & L ventricle.
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| show | May be asymptomatic if opening is small. Harsh murmur with a thrill, s/s of HF (SOB, feeding difficulties, crackles, pulmonary infections, poor growth, fatigue, congestion)
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| How is VSD diagnosed? | show 🗑
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| What is the treatment for VSD? | show 🗑
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| What is ASD? | show 🗑
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| show | may be asymptomatic, may or may not have a murmur, s/s of HF (SOB, resp distress, failure to thrive, periorbital edema, resp infections)
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| How is ASD diagnosed? | show 🗑
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| What is PDA? | show 🗑
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| what are the s/s of PDA? | show 🗑
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| show | S/S and machine like murmur under L clavicle; echo. Cardiac Cath is not necessary!!
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| show | Indomethacin or Ibuprofen IV. The administration will force closure of the ductus arterious. This is very successful in premies. If IV meds don't work, ligation will be done.
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| What do you expect to see in assessment for all acyanotic CHD? | show 🗑
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| show | 0.5-2; assess apical, hold if <60. Give water to rinse mouth after admin bc it can harm teeth.
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| show | halo, nausea, vomiting, decreased appetite
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| show | administer Digibind. Low K potentiates Dig, so monitor K levels
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| Lasix is potassium wasting, therefore important to monitor what? How is Lasix given to children? | show 🗑
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| May be given prophylactic antibiotics to prevent what? | show 🗑
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| show | Tetralogy of Fallot and Transposition of the Great Vessels. Right to Left shunting so deoxygenated blood goes to body. TETs is the most common cyanotic defect.
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| What 4 defects make up TETs? | show 🗑
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| What is overriding aorta? | show 🗑
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| what is pulmonary stenosis? | show 🗑
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| what causes R ventricular hypertrophy? | show 🗑
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| show | During crying, exercise, or feedings. The child become very blue.
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| What causes polycythemia to occur with TETs? | show 🗑
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| What are the s/s of TETs? | show 🗑
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| What will see children of TETs do alot? | show 🗑
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| How is TETs diagnosed? | show 🗑
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| show | Sqautting or knees to chest to help facilitate blood flow; oxygen therapy; and surgery to repair the defects (VSD, Overriding Aorta, Pulmonary stenosis, R Vent Hypertrophy)
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| show | Heart failure and stroke (due to polycythemia causing clots)
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| what is transposition of the great arteries (vessels)? | show 🗑
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| Why doesn't the newborn die from transposition of the great arteries? | show 🗑
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| show | thru clinical presentation. Infant will be cyanotic as the PDA closes.. cyanotic all the time!! Chest xray, Echo, and Cardiac cath (100% definitive)
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| show | Prostaglandin Infusion to keep the ductus arteriosus & foramen ovale open until surgery can be done. Atrial septostomy to put a larger opening in so blood can continue to flow & eventually an atrial switch procedure to switch the location of the vessels
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| show | Coarctation of Aorta; Aortic Stenosis, Hypoplastic L Heart syndrome
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| show | stenosis or narrowing within the thoracis aorta.
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| what are the s/s of coarctation of the aorta? | show 🗑
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| How is coarctation of the aorta diagnosed? | show 🗑
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| show | balloon angioplasty and stent placed; more severe cases, may have to cut out the stenotic part and reanastomose the vessels.
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| What is aortic stenosis? | show 🗑
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| What are the s/s of aortic stenosis? | show 🗑
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| show | s/s; chest xray (enlargement); echo; cardiac cath
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| what is the treatment for aortic stenosis? | show 🗑
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| show | L vent doesn't develop like it should and will not work properly-body will not get enough O2. You will see cyanosis immediately at birth (hours), hypotension, tachycardia.
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| How is Hypoplastic L heart diagnosed? | show 🗑
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| What is the treatment for hypoplastic L heart? | show 🗑
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| show | rare childhood disease; characterized by swelling of arteries (usually cardiac). It is NOT contagious but may occur from virus or bacteria. Unknown cause.
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| show | between 2-5 yrs; boys; Asian
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| show | FIRE! You will see multisystem vasculitis; ectasia (dilation of coronary arteries); pancarditis
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| 10-40 days, what occurs in Kawasaki? | show 🗑
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| show | progressive fibrosis and healing
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| What are the s/s associated with the acute phase of Kawasaki? | show 🗑
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| show | peeling of toes/fingers (desquamation); joint pain; diarrhea and vomiting.
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| How is Kawasaki diagnosed? | show 🗑
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| How is Kawasaki treated? | show 🗑
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| show | admin immune globulin and ASA; monitor for s/e and results; assess for s/s CHF; quiet supportive environment; soft foods and cool nonacidic liquids.
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