3340: PEDS CARDIOVASCULAR Flashcards
S/S of Heart Disease in Children?
Frequent Respiratory Infections and Dyspnea Activity Intolerance Difficulty and Fatigue during Feedings Failure to thrive, Low weight Pallor, cyanosis, clubbing
Feeding Interventions for Children with Heart Disease?
Provide periods of uninterrupted rest
NTE
Feed child slowly and more often (30min Q3H)
Hold infant upright
Place infant on right side after feeding, HOB (30-45)
When does pallor and cyanosis usually occur in a child with heart disease?
during feeding
What are the two reasons for Pediatric CHF?
Structural Problems
Weakness of Actual Heart Muscle
What is the most common cause of Pediatric CHF?
Congenital Heart Defects
S/S of R sided HF
Periorbital and Facial Edema Enlarged Liver or Spleen Ascites Wheezing Neck Vein Distension (JVD)
S/S of L sided HF
Tachypnea Dyspnea Crackles Intercostal/Sternal Retractions Wheezing
Causes of R sided HF
Left to Right Shunts (VSD, ASD)
Causes of L sided HF
Right to Left Shunts (PDA, COA)
What type of heart failure do most pediatric CHF patients have?
Combination of Right and Left
3 early signs of CHF in infants/children
Tachypnea
Poor feeding
Diaphoresis during feeding
Medications for Pediatric HF
Positive Inotropes
Diuretics
After-load reducing drugs
Digoxin (Lanoxin)
Increases the force of muscular contraction in the heart
Slows and strengthens the heart
Positive inotropic action
Monitor: Dig level, K+, Mg2+, Ca2+
S/S of Digoxin Toxicity
Nausea Vomiting Anorexia Bradycardia Dysrhythmia
When do you hold Digoxin and call HCP?
If infant/toddler HR is <100
If child HR is <70
If contraindicated
Furosemide (Lasix)
Loop diuretic that blocks sodium reabsorption in the ascending loop of henle
Decreases preload by increasing water excretion
SE: electrolyte imbalances (decreases K+ and Mg2+),
Spironolactone (Aldactone)
Potassium-sparing diuretic
Decreases preload
3 Components of Stroke Volume
- Preload
- Afterload
- Contractility
In fetal circulation what does the Ductus Venosus Connect?
IVC to Umbilical Vein