Cardiovascular Dysfunction Flashcards

Question

Congenital heart treatment

Answer 1

Surgery - Total anomalous pulmonary venous drainage - at birth - Transposition of great arteries - within a few days - A few months or years later, depend on : Age Overall health, extent of disease Expectations for the course of defects Temporary shunt to redirect the blood flow

Answer 2

- Ventilator - Intravenous catheters - Extracorporeal membrane oxygenation ( ECMO ) - Arterial line - Nasogastric tube - Urinary catheter - Chest tubes - Cardiac monitor - Medication - Long term care management

Answer 3

Presentation : Cardiac abnormalities that present in similar manner to children with decreased myocardial contractility, myocarditis or coronary insufficiency. - Inflammation of blood vessels - Affects mucus membrane, lymph nodes, walls of blood vessels and the heart

Answer 4

High fever persisting for at least 5 days • Rash: Polymorphous exanthema, never vesicular or bullous • Red eyes without discharge • Erythema and cracking of lips, strawberry tongue • Cervical lymphadenopathy (>= 1.5cm in diameter) • Acute: erythema and oedema of hands and feet. Convalescent: skin desquamation of the tips of fingers and toes

Answer 5

7-14 days, characterized by fever and inflammatory changes

Answer 6

Approximately next 10-25 days after onset of condition • Irritablity, anorexia, conjunctival injection persist • Desquamation of fingers and toes • May have arthritis and arthralgia • Myocardial dysfunction • Thrombocytosis is common

Answer 7

6-10 weeks when clinical signs returns to normal

Answer 8

1. Hematological - Raised ESR and CRP, mild anemia, thrombocytosis 2. Cardiovascular and Respiratory - Cough, rhinorrhea - Echogram - structural abnormalities, cardiomegaly - Tachycardia, S3 gallop rhythm, murmur of mitral/aortic regurgitation - Chest radiography- cardiomegaly - Signs of cardiac failure - Pulmonary congestion 3. Renal - Hypoalbuminemia - Occasional proteinuria 4. Gastrointestinal - Diarrhea - Vomitting - Abdominal pain

Answer 9

Intravenous Immunoglobulin (IVIG) • Primary treatment in patient with KD • Administered within first 10 days • Dose: 2g/kg as a single infusion (start slow and increase rate gradually) • Close monitoring during infusion eg. Vitals Q10mins x 3 then Q15mins, Q30mins Aspirin • Anti-inflammatory and anti-pyretic • Stop after 6-8 weeks if echo is normal 2D Echogram • During subacute phase to detect cardiovascular changes • Day 14 2D echogram to review condition

Answer 10

``` 1. Promote adequate cardiac output and oxygenation • Monitor vital signs • Observe and manage hypoxia • Administer oxygen and medication • Decrease cardiac workload ``` 2. Monitor for signs of altered cardiac output • Pulmonary edema • Arrythmias: tachycardia or bradycardia 3. Monitor for signs of respiratory distress • Administer oxygen as prescribed • Elevate head of bed to facilitate breathing • Monitor blood gas

Answer 11

``` Decreased cardiac output • Ineffective tissue perfusion: Cardiovascular • Activity tolerance • Imbalanced nutrition • Risk for infection • Delayed growth and development • Ineffective breathing pattern • Excess fluid volume ```

Answer 12

Reduce cardiac demand • Keep child warm • Schedule nursing intervention • Allow rest in-between feeds. Consider Speech Therapist referral • Oral/Naso gastric feeding if infant becomes fatigue Promote adequate nutrition • Daily food intake and weight gain • Well balanced diet, frequent feeding/meals • Dietician referral: high calorie and low sodium diet Evaluate fluid status • Strict fluid intake and output measurement • Monitor daily weight and edema • Monitor electrolytes value Prevent Infection • Immunizations