cardiac Flashcards
cath lab nc - preop
right side
assess, npo 4-6 (am meds), iv fluids?, height and weight, dev appropriate, no diaper rash, sedation?, mark pedal pulses
cath lab nc - post op
freq vs, color and loc, pulse distal are weaker, pressure dressing (circle, pressure 1” above site and call for help, notify hcp), flat for a few hours, fluid intake, hypoglycemia
cath lab nc - dc
pressure dressing for 24 hours, no tub baths 24 hrs, rest that night, then normal activities, s/s infection
chf tm
improve cardiac function, remove fluid and Na, decrease cardiac demands, improve tissue oxygenation and decrease oxygen consumption
digoxin
regula intervals, 1 hr before or 2 hrs after eating, apical rate for 1 min (hold <90 or 70), dont mix, behind teeth or brush, dont give if >4hrs after, 2 missed call hcp, dont repeat with vomit, check k levels (hold if low)
digoxin toxicity
nv, bradycardia, anorexia, neuro and visual disturbances
monitor for dysrhythmias
digibind - watch k
activity intol nc
promote rest, prevent cry, group activities, short play, cuddle, neutral temp, supplemental o2? (not to keep above 90)
altered nutrition nc
anticipate hunger, small and freq, burp, dont feed >30 min - ng, relaxed env, semi erect, formula with increased cal/ounce, soft preemie nipple
ineffective breathing pattern nc
assess rr, effort, o2 sat, position for max chest expansion, avoid constriction, humidified o2 during stressful periods
potential for infection nc
avoid crowded public places, hh, screen visitors
fluid volume excess nc
I+O, weigh daily, edema, fluid restriction, skin care, change position freq
family ed nc
s/s of worsening status, med info, good nutrition (high cal needs and get tired easily), immunizations, promote g+d
aortic stenosis
not bed rest but activity restriction
polycythemia
with cyanotic defect
blood thickens compensate for low oxygen - clots! (watch for, prevent, dont let dehydration happen), one leg larger than the other, redness, warm, H+H
tet spells
calm and comfort, knee to chest, oxygen, morphine, iv fluids, morphine
prostaglandin E
maintain foramen ovale
Bacterial endocarditis tm
iv abx 2-8 wk, remove emboli, valve replacement
prevention: prophylactic abx 1hr before sx
BE nc
proyphylactic abx, teach iv abx at home, s relief (joints), monitor for emboli
RF tm
strep affects the heart
get rid of strep
prevent heart damage and relieve s: salicylates for inflam (reye’s), steroids for imflam, bed rest
prevention of recurrence and endocarditis: prophylactic abx
RF nc
prevent, compliance with drugs (esp prophylactic), recovery, emotional support
kawasakis tm
salicylates - inflam and platelet
IVIG w/n 10 days of fever starting
kawasakis nc
monitor cardiac status, large volume = IVIG and blood, s relief: skin, mouth care, clear liquids and soft food, irritable, discharge teaching, immunizations (aspirin and varicella), MI
cardiomyopathy tm
digoxin, diuretics, beta blockers, ccb, anticoag, transplant
cardiomyopathy nc
hard to adjust (activity), include kid in discussion, teach psych prep for transplant and post op care
BE etiology
bacteria enters through infection site and goes to heart
BE cm
low grade intermittent fever, anorexia, weight loss, joint pain, and blood culture, new heart murmur or change in existing, petechiae of mucous membranes, janeway spots, osler nodes, splinter hemorrhage under nails
RH etiology
systemic inflammation from strep, weakens valve
RH cm
polyarthtritic, carditis, chorea, erythema marginatum sq nodules, arthralgia, low grade fever, elevated ASO titer, abd pain
kawasaki etiology
acute systemic vasculitis
convalescent phase dangerous bc MI with emboli
general cm for heart defects
dyspnea, feeding difficulty, stridor/choking, >200 bpm, rr~60, recurrent rti, poor phys dev, delayed, exercise intol, cyanosis, clubbing, squat or knee-chest, heart murmu, excessive sweating, s of HF
