Peds exam 2 - Acquired Cardiac Flashcards
bacterial endocarditis
an inflammatory process resulting from infection of the valves and inner lining of the heart
can occur from a line or dental procedure, ect
clinical manifestations of bacterial endocarditis
janeway spots, osler nodes, splinter hemorrhages under nails
-petechiae
-anorexia
-joint pain
-murmur
bacterial endocarditis therapeutic mgt
-IV antibiotics for 2 to 8 wks
-surgical removal of significant emboli and/or valve replacement
-prevention: prophylactic antibiotics 1hr before risky procedure for high risk kids
nursing considerations of BE
-teach prophylatic antibiotic therapy
-teach family to give IV antibiotics at home
-symptomatic relief
-monitor for emboli
rheumatic fever
a systemic inflammatory disease that follows a group A beta hemolytic streptococcus infection in mitral valve
untreated strep which leads to infection of heart which can lead to damage & backflow
incidence & etiology RF
-school aged children
-strep infection a few weeks prior to dx
-more common in males during late winter & early spring
clinical manifestations of RF: major
-polyarthritis
-carditis
-chorea (shakiness, dont do fine motor things)
-erthema marginatum (large red dots)
-subcutaneous
clinical manifestations of RF: minor
-arthralgia (joint pain)
-low grade fever
-elevated ASO titer
-abdominal pain
therapeutic mgt of RF
-eradication of beta hemolytic streptococci (strep) w/ cillin antibiotic
-prevent cardiac damage so will be on aspirin therapy for a couple weeks
-steroids
-bed rest
-give prophylactic antibiotics before any procedure for rest of life
at what age can we start giving aspirin
do not give aspirin until a person is 18 yrs old bc of ryes syndrome but will give to children w/ RH bc the benefits outweighs the costs
nursing considerations of RF
prevent the disease
-encourage compliance w/ drug regimens esp prophylactic
-teach about aspirin therapy and reyes symptoms let us know if viral infection occurs so we can determine if we need to dc aspirin
-facilitate recovery
Kawasaki Disease (mucocutaneous lymph node syndrome)
acute systemic vasculitis of unknown etiology w/ possible infectious component
body wide inflammation of veins, capillaries, coronary arteries
Kawasaki Disease clinical manifestations: acute phase (8-10 days)
-fever does not respond to tyl or ibpro
-pruritic polymorphic rash
-cervical lymphadenopathy
-dry, red, cracked lips
-strawberry tongue
-bilateral pink eyes w/o the junk
-erythema & swollen palms
Kawasaki Disease clinical manifestations: subacute phase (10-35 days)
starts when fever goes away
-vasculitis
-desquamation of toes, feet, fingers & palms
-arthritis
-thrombocytosis
Kawasaki Disease clinical manifestations: recovery phase (up to 10 wks)
-symptom free
-complete when all blood values return to normal
-most dangerous phase bc embolisms can form and the kids are at an increased risk of MI
nursing intervention of kawasaki disease
-most babies will get better on their own but 20% develop serious cardiac sequelae so we treat them all
sign / symptoms of myocardial infection in children
-pain in chest or back or no symptoms at all
-abdominal pain
-restlessness
-inconsolable crying
-pallor
-shock
therapeutic treatment for KD
-high dose aspirin for anti inflammatory and then low dose for anti platelet
-if fever is caught within 10 days can give IVIG to decrease heart problems watch fluid overload
-vitals & I&Os & daily wts
-IVIG is blood so vitals 15 mins before & after and then every hour until finished
