child health

Question 1

Cyanotic defects are more critical than acyanotic defects

Answer 1

because they cause
hypoxemia, hypercyanotic (“tet”) spells, and polycythemia.

Question 2

Treat hypercyanotic spells by

Answer 2

comforting and
positioning the infant knees to chest. Administer 100% oxygen, morphine, and IV fluids (PRN).

Question 2

Tetralogy of Fallot (TOF):
Four defects:

Answer 2

1. Pulmonic stenosis-FINDINGS
   Murmur
   TREATMENT
   Balloon angioplasty to dilate the narrowing
2. Right ventricular hypertrophy
3. Ventricular septal defect (VSD)
4. Overriding aorta (aorta positioned over
   VSD instead of LV)

Question 3

TREATMENT

Answer 3

Treat hypercyanotic (“tet”) spells
Surgical repair during first year of life

Question 4

FINDINGS

Answer 4

Hypercyanotic (“tet”) spells
(more common in TOF)

Question 5

Coarctation of the aorta

Answer 5

causes BP to be higher in the upper extremities than in the lower extremities.

Question 6

Maintaining fluid balance and optimizing perfusion:

Answer 6

Dehydrationstroke risk in children with polycythemia
Use IV air filters to prevent air embolism in R  L shunts (TOF).

Question 7

Offer children with CHD

Answer 7

small, frequent feedings
to conserve energy and reduce oxygen demand.

Question 8

If severe, acyanotic defects

Answer 8

cause signs of
heart failure, like dyspnea, fatigue, and
sudden weight gain.

Question 9

4. Postoperative Care
   CHD is diagnosed with echocardiogram or cardiac
   catheterization.

Answer 9

If infant has diaper rash, cardiac catheterization must
be delayed. Postoperative cardiac surgery care (for TOF, TGA):
Monitor for bleeding:
Notify HCP if chest tube output >3 mL/kg/hr for
3 consecutive hrs or ≥5-10 mL/kg for 1 hr.

Question 10

Monitor for decreased cardiac output:

Answer 10

Assess BP and HR.
Notify HCP if urine output <1 mL/kg/hr.
Monitor for and prevent infection:
Notify HCP of fever or purulent drainage on dressing.
Keep incision clean and dry.
No tub baths for 3 days after surgery.
Take antibiotics before dental procedures torisk for infective endocarditis.