week 3 - cardiac care peds

Question 1

what can go wrong when it comes to paediatric cardiac care?

Answer 1

congenital heart defect and acquired heart disorders

Question 2

go more in depth when it comes to congenital heart defects?

Answer 2

this is Anatomical abnormalities present at birth

two examples: ventricular septal defect, tetralogy of fallout (4 heart defects)

Question 3

what is acquired heart disorders?

Answer 3

Disease or abnormalities that occur after birth
Examples:
* Infection - cardiac comp from the result of infection ex. myocarditis after covid) or rheumatic fever - rheumatic heart disease
* Autoimmune responses
* Environmental factors - exporsure to pollutions, chemicals or toxins
* Family tendencies

Question 4

what are the symtpoms of congenital heart defects?

Answer 4

children can be asymptomatic to severe symptoms
cyanosis and heart failure
Tachycardia
* Weak peripheral pulses
* Decreased blood pressure
* Anorexia
* Decreased U/O
* Sweating(inappropriate) - forehead and scalp
* Weakness/Fatigue - falls asleep mid feeding
Tachypnea
Dyspnea
Flaring nares*
Wheezing
Grunting*
Weight gain
Peripheral edema (esp periorbital
Neck vein distension (children)
Ascites

Question 5

what are the diagnostics for CHD?

Answer 5

Procedures for Cardiac Diagnosis
* Chest X-ray 5 minutes
* Electrocardiograph (ECG) 15 mins
* Echocardiogram (Echo) 1 hour
* Exercise stress test 15 minutes +
* Cardiac MRI 30 mins +
* Cardiac catheterization (angio) 1 hour

Question 6

what are some important points to remember? with diagnostics

Answer 6

Important Points to Remember…
* Stressful (for child and parent)
* Child must stay still for most tests * Immobilizers
* Mild sedative
* Psychological preparation
* Distraction (movie, music)
* Important to communicate information at an age-appropriate level for child and parent/care-giver
* Recovery same as adults but with age-appropriate adaptations

Question 7

how do you manage cyanosis with CHD?

Answer 7

“Hypercyanoticspells”or “Tet” spells can occur suddenly
* Often occur during blood draw or IV insertion (child is upset)
Nursing Intervention:
* Place infant in knee- chest position
* Administer 100% oxygen
* Give morphine
* Remain calm

Question 8

what is the goal of care? and what do you do abt it?

Answer 8

improve cardiac function
Medication:
* Digoxin
* ACE Inhibitors
* Beta Blockers
Nursing Care:
* Dose calculation
* Assess vital signs pre and
post med admin
* Monitor for dig toxicity * Assesspatientresponse

Question 9

another goal of care is remove excess fluid, what are some interventions/nursing care?

Answer 9

Interventions:
* Diuretics
* Fluid Restriction
* Na Restricted diet

Nursing Care:
* Dose Calculation
* Vital Signs
* Monitor Ins & Outs
* Monitor weight

Question 10

goals of care: decrease cardiac demands, what are the interventions/nursing care:

Answer 10

• Keep infant temperature normal
• Treat infections
• Reduce breathing effort (semi-fowlers)
• Sedate irritable child
• Provide restful environment

Question 11

goals of care: improve tissue oxygenation, what are the interventions/nursing care?

Answer 11

• Monitor oxygen saturation
• Administer supplemental oxygen as ordered (cool humidity)
• Assess patient’s response to oxygen
• Reduce respiratory distress

Question 12

goals of care: maintaining nutritional status - interventions/nursing care for infants?

Answer 12

• Feed when well rested
• Frequent shorter feeds
• Supplemental gavage feedings if required Calorie-dense formula may be used

Question 13

true or false: Approximately 50% of children with a CHD will require some type of surgery.

Answer 13

true

Question 14

what are the family education for congenital heart defect

Answer 14

Nurses will teach families how to manage at home:
* Medication (esp signs of toxicity)
* Activity tolerance/Rest
* Nutrition (high caloric needs)
* Signs of deterioration (what to do)