cardiac

Question 1

cath lab nc - preop

Answer 1

right side
assess, npo 4-6 (am meds), iv fluids?, height and weight, dev appropriate, no diaper rash, sedation?, mark pedal pulses

Question 2

cath lab nc - post op

Answer 2

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

Question 3

cath lab nc - dc

Answer 3

pressure dressing for 24 hours, no tub baths 24 hrs, rest that night, then normal activities, s/s infection

Question 4

chf tm

Answer 4

improve cardiac function, remove fluid and Na, decrease cardiac demands, improve tissue oxygenation and decrease oxygen consumption

Question 5

digoxin

Answer 5

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)

Question 6

digoxin toxicity

Answer 6

nv, bradycardia, anorexia, neuro and visual disturbances
monitor for dysrhythmias
digibind - watch k

Question 7

activity intol nc

Answer 7

promote rest, prevent cry, group activities, short play, cuddle, neutral temp, supplemental o2? (not to keep above 90)

Question 8

altered nutrition nc

Answer 8

anticipate hunger, small and freq, burp, dont feed >30 min - ng, relaxed env, semi erect, formula with increased cal/ounce, soft preemie nipple

Question 9

ineffective breathing pattern nc

Answer 9

assess rr, effort, o2 sat, position for max chest expansion, avoid constriction, humidified o2 during stressful periods

Question 10

potential for infection nc

Answer 10

avoid crowded public places, hh, screen visitors

Question 11

fluid volume excess nc

Answer 11

I+O, weigh daily, edema, fluid restriction, skin care, change position freq

Question 12

family ed nc

Answer 12

s/s of worsening status, med info, good nutrition (high cal needs and get tired easily), immunizations, promote g+d

Question 13

aortic stenosis

Answer 13

not bed rest but activity restriction

Question 14

polycythemia

Answer 14

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

Question 15

tet spells

Answer 15

calm and comfort, knee to chest, oxygen, morphine, iv fluids, morphine

Question 16

prostaglandin E

Answer 16

maintain foramen ovale

Question 17

Bacterial endocarditis tm

Answer 17

iv abx 2-8 wk, remove emboli, valve replacement
prevention: prophylactic abx 1hr before sx

Question 18

BE nc

Answer 18

proyphylactic abx, teach iv abx at home, s relief (joints), monitor for emboli

Question 19

RF tm

Answer 19

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

Question 20

RF nc

Answer 20

prevent, compliance with drugs (esp prophylactic), recovery, emotional support

Question 21

kawasakis tm

Answer 21

salicylates - inflam and platelet
IVIG w/n 10 days of fever starting

Question 22

kawasakis nc

Answer 22

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

Question 23

cardiomyopathy tm

Answer 23

digoxin, diuretics, beta blockers, ccb, anticoag, transplant

Question 24

cardiomyopathy nc

Answer 24

hard to adjust (activity), include kid in discussion, teach psych prep for transplant and post op care

Question 25

BE etiology

Answer 25

bacteria enters through infection site and goes to heart

Question 26

BE cm

Answer 26

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

Question 27

RH etiology

Answer 27

systemic inflammation from strep, weakens valve

Question 28

RH cm

Answer 28

polyarthtritic, carditis, chorea, erythema marginatum sq nodules, arthralgia, low grade fever, elevated ASO titer, abd pain

Question 29

kawasaki etiology

Answer 29

acute systemic vasculitis
convalescent phase dangerous bc MI with emboli

Question 30

general cm for heart defects

Answer 30

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