Peds Exam 1 - Blood, Heart, Perfusion Flashcards
what are the examples of an increase in pulmonary flow for a cardiac defect
VSD
AVD
PDA
what happens with the congenital heart defect that increases pulmonary flow
the left heart is hypertrophied, pressure increase
increase in lung circulation
wet lung sounds increase in respiratory rate increase in metabolic rate increase in heart rate poor feeding and fatigue frequent respiratory infections
all are symptoms of what?
heart defect – increase in pulmonary flow
nursing considerations for VSD
supplement nutrition
strict intake and output –> CHF
what happens during a restrict in blood flow
obstruction in blood flow to right heart, decrease in oxygenated blood
dyspnea cyanosis that does not improve from o2 loud murmur fatigue while feeding knee to chest positioning in child is an example of what congenital heart defect
restrict in blood flow
what are the types of heart defects that restrict blood flow
tetralogy of fallot
coarction of the aorta
hypo plastic left heart
what are the defects in tetralogy of fallot
pulmonary stenosis
overriding aorta
right ventricular hypertrophy
VSD
what is an outcome of teratology of fallot
a tet spell
characteristics of a tet spell
diminish in heart murmur
rapid deep breathing
worsening cyanosis
uncontrollable crying and panic
what can cause a tet spell
agitation and crying
early morning after awakening
noxious stimuli
what is a bad sign during a tet spell
heart murmur goes to bay
why is a diminished heart murmur bad during a tet spell
pulmonary blood flow is severely compromised
what makes up a tet treatment
positioning
reducing irritable stimuli
oxygen
opiods
during tachycardia in a child - what meds would be best
lanoxin
lasix
Ace inhibitors
what would be good education for a child with a increase in pulmonary flow heart defect (i.e. PDA, AVD,VSD)
it may close!
if before 6 mos old
opening in atrial septum
AVD
blood shunted into the pulmonary artery
VSD
mix of pulmonary blood into aorta
PDA
what is affected during hypoplastic heart
mitral, left ventricle, aortic valve
why does hypo plastic left heart happen
the left side of the heart is under developed
what is the coarction of the heart?
skinny narrow part of the aorta
manifestations of CHF
dyspnea
tachypnea
intercostal retractions
what is rheumatic fever
autoimmune connective tissue disorder
what are manifestations of rheumatic fever
J - oints O - "endocarditis" i.e. heart infection N - odule E - rythema S - haking
what causes rheumatic fever?
uncontrolled strep throat, not treated
what is a common side effect of rheumatic fever?
scarring of the mitral valve
what may happen if mitral valve scarring happens in rheumatic fever?
murmur may develop
positive diagnosis of rheumatic fever?
2 JONES criteria and recent strep infection
nurse management of rheumatic fever?
prevent strep monitor vitals auscultate heart anti-biotics long term anti bionics baseline EKG
who does rheumatic fever effect the most?
school aged children and toddlers
what is kawasaki disease?
systemic vascular inflammatory disorder (autoimmune)
who does kawasaki effect the most?
younger than 5!
abrupt sustained fever irritable heart problems red cracked lips peeling or nails and hands red eyes swollen lymph nodes rash
kawasaki disease
ECG
IVIG
high dose aspirin followed by low dose QID
kawasaki disease
lube lips temp before aspirin weigh keep skin cool and dry change clothes and linens small feedings passive ROM post pone varicella and measles vaccine
kawasaki disease nursing management
blood transfusion “good to know”
low and slow
gradually increase
stop for reaction - Benadryl if mild
what may cause iron deficient anemia
rapid growth
infant not on solids
iron deficient maternal source
what are manifestations of iron deficient anemia
pallor and fatigue poor feeding irritability pica tachypnea drop in BP and chest pain
what is an indicative HgB level for anemia?
below 11
what is a dangerous cardiac output anemia?
below 8
what triggers sickle cell
dehydration
infection
physical/emotional stress
cold exposure
what is a complication of sickle cell anemia
hemosiderosis (iron deposits in organs)
manifestations of sickle cell
iron deficient symptoms
pain crisis symptoms
fever tissue engorgement PAIN swelling in hands and feet abdominal pain
what are side effects of a pain crisis.. “what can happen?”
pulmonary acute chest syndrome
what are side effects of pulmonary acute chest syndrome
pulmonary infection
chest pain
cough
dyspnea
treatment of sickle cell
ibuprofen opioids tylenol oxygen bedrest
ITP what is
acquired platelet disorder, platelet count is low
what are symptoms of ITP
easy bruising
platelet count until 20,000
treatment of ITP
IVIG
what is hemophilia
clotting disorder, does not clot normally
how to test for hemopholia
heel stick in newborns
manifestations of hemophilia
spontaneous bleeding bruising bleeding into joints hematuria circumcision bleeding
how to treat hemophilia
give the clotting factor (supplement)
what kind of disorder is unique to childhood
platelet disorder
what is leukemia
most common child hood cancer
immature WBC take over RBC organs
what does leukemia cause
anemia
what does leukemia look like
the flu!
what are some exclusive leukemia symptoms
nose bleeds
gi ascites
enlarged lymph
what will leukemia labs look like
high calcium and high WBC
what is a rule of thumb of what sickle cell anemia effects
brain
lung
abdomen
eyes
