Unit 2 Flashcards
data findings for a child with CHD
- respiration abnormalities and infection
- clubbing (chronic hypoxia) !
- sweating !
- activity intolerance !
- need of frequent rest periods !
- abnormal color, pulses, rhythm, and cap refill
- fatigue during feeding !
what are the acyanotic defects
PDA, ASD, VSD
THEY INCREASE PULMONARY FLOW
SHUNTS BLOOD LEFT TO RIGHT
what is ASD? s/s? severity? tx? complications?
atrial septic defect (hole between the atria
s/s: murmur
- not that severe
tx: surgery, may close randomly, dacron patch/suture
complications: stroke and heart failure
what are s/s of PDA
- dyspnea, wide pulse pressure present, radial pulse full and bounding on exertion
in COA what happens to the vessels
they are pinched or narrowing
s/s of COA
- elevated bp and bounding pulses in upper extremities
- decreased or absent pulse and decreased bp in lower extremities
- leg pain post-exercise
is a cyanotic defect
TOF (makes heart look like boot)
- shunts blood from right to left
what are the 4 abnormalities of TOF
- stenosis
- VSD
- displaced aorta
- hypertrophy of right ventricle
never let a baby do what in cardiac
cry for a long time
what does a cardiac catheter show
blood pressure within heart
after a cardiac catheterization the px should not do what
px should not move and leg should stay still
what age is a cardaic cath done in an infant/kid
4 months - 2 years old
what should the pulse rate be on an infant if you want to give digoxin
if pulse rate of infant is lower than 100 bpm hold the med
what should the pulse rate be on an older child if you want to give digoxin
to give digoxin to an older child pulse rate should be more 70 bpm
how long do you count apical pulse for to give digoxin
count apical pulse for 1 full minute
how many nurses do you need to verify digoxin dose? can you skip doses? can you make up doses? can you mix it with food or formula?
- need two nurses to verify digoxin dose
- do not skip dose
- do not make up dose
- do not mix with food or formula
what are the s/s of TOF
cyanosis increase with age
clubbing fingers
growth retardation
respiratory infections
feeding problems
syncope
s/s of kawasaki disease?
- strawberry tongue
- peeling skin
- increased platelet and coagulation labs
- abrupt fever
if you have Kawasaki disease what do you do about immunizations
postpone immunizations for 11 months if you have Kawasaki disease
tx of Kawasaki disease
IVIG
- aspirin for anticlotting
what is the big difference between croup and other respiratory problems
barky cough
what kind of precaution is RSV
contact precaution
what will you hear with RSV
wheezing
if px have tonsillectomy and is frequently swallowing what could be happening
px could be bleeding in throat
with tonsillectomy what do you avoid
avoid milk, red dyes, coughing, sneezing
what medication is used for exercise-induced asthma? do not use this med for what?
cromolyn
- do not use Cromolyn for acute episode
how do you relief tet spells in infant with TOF
knee to chest position
what are the early signs of heart failure
- tachycardia
- fatigue during feedings
- sweating
- dyspnea
- weight gain
s/s of left-sided heart failure
LEFT SIDED HEART FAILURE IS LUNGS
- tachypnea
- cough, crackles
- blood-tinged sputum
s/s of right-sided heart failure
RIGHT SIDED HEART FAILURE IS GI
- enlarged liver
- ascites
- weight gain/dependent edema
- gi distress/ anorexia
- distended jugular veins
administer what when a baby is crying
oxygen
s/s of bronchitis (RSV)
- mild fever, serous nasal discharge , wheezing cough
what is epiglottis? caused by? is there a cough? severity?
swelling of tissue above vocal cords
- cough is absent
- caused by influenzae B
- life threatening
what are s/s of asthma
- wheezing, restlessness, and itchy chest, shortness of breath
what kind of stool do you have with cystic fibrosis
bulky foul smelling stool that is frothy
thick impacted feces from cystic fibrosis can cause what
rectal prolapse
what diet is px on with cystic fibrosis
high protein
high calorie
what kind of chest does a CF px have
barrel chest
do you swab anything on px if they have epiglottitis
NO do not swab at all
goals of CF treatment
fat soluable vitamins ( ADEK)
give pancreatic enzymes with apple sauce
infection prevention is key
what Hgb and Hct value do you suspect anemia
less than 11g/dl for Hgb
Hct less than 33
for iron deficiency anemia take supplements with what? avoid what?what does the stool look like?
take with straw, vitamin C, on empty stomach
- no dairy products 1 hr before or 2 after
- green tarry stool
do not give cows milk to child before what age
1
what triggers a sickle cell attack or crisis
- exposure to cold
- dehydration
- infection
- ## physical or emotional stress
how do infants perceive death
they dont
how do toddler perceive death
it is just separation or abandonment
how do preschooler perceive death
reversible or in deep sleep state, death is temporary
how do school age children perceive death
realize death is final by 8-9 y/o
decrease in sense of belonging
how do adolscents perceive death
they feel anger and resentment
less future-oriented
trouble accepting diagnosis
s/s of death
slow breathing, grey skin, vital signs drop
how to educate on prevents SIDS
put to sleep on back
