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Concepts Of Materna (NUR 4130) Peds Final - SG - Professor Lewis

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John Marsh
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Peds final – SG – Professor Lewis. This study guide contains information covered on the pediatrics-nursing rationales

Nova Southeastern University

Concepts Of Maternal-Child Nursing And Families (NUR 4130)

General cardiac: meds, s/s of heart failure
1. Cardiac- murmurs we talked about and what defect they come with
 Congenital Heart Defects- Babies are born with this cardiac dysfunction
o 3 types
 Acyanotic (ASD, VSD, PDA)
 Obstructive (coarctation of the Aorta)
 Cyanotic (tetralogy of Fallot) 4 types: (Ventricular septal defect,
Pulmonary stenosis, overriding aorta, right ventricular hypertrophy)
 Acquired Heart Defects
o Occurs after birth (infection/autoimmune disease)
 Atrial septum defect (ASD)
o Abnormal opening between the 2 atria
o Acyanotic
o S/s: difficulty breathing when feeding
o Left side has more pressure so oxygenated blood pushes to the rt. causing
pulmonary hypertension and cause right sided heart failure
 Ventricular Septal Defect (VSD)
o Abnormal opening between the 2 ventricles
o Acyanotic
o S/s: same as ASD
o Murmur sounds like a loud motorcycle
o If baby is sweating while feeding baby is showing signs of distress
 Patent Ductus Arterious (PDA)
o Ductus arteriosus connecting the aorta and pulmonary artery stay open (should
close at birth and turn into a ligament)
o Acyanotic
o Machinery like sound
o Management: NSAID given (Indomathacin)
o S/s: same asd, vsd, pda (all acyanotic) all can lead to congestive heart failure
because of left to right shunts
 Left to right shunt common management
o Diuretics (Lasix)
o Digoxin but hold if bradycardia – infant less 100 bpm or toddler no less than 80
o Tell the parent it slows and helps pump blood better from the heart
o Soft nipple with bigger opening when feeding
o High calorie formula b/c they burn so much calories from the heart issue and
respiratory problems from this disease
o Normal urine output 1-2 ml/kg/hr
 Coarctation of the aorta (COA)
o Obstructive, Acyanotic defect
o Poor perfusion
o High pressure close to the area of the aorta (like the brain)
o High bp in upper extremities and lower bp in lower
o Bounding brachial pulses in comparison with femoral pulses and legs (weak or
absent)
o Echo can be done first , determines structure
o Child can have leg cramps due to poor perfusion (hypoxic tissue)
o Nose bleeds
o headaches
 Catheterization – keep leg straight, and pressure in the site
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 Only treated invasively when symptomatic (good to know)
2. Cardiac babies-
 Blood flow of the heart
 Inferior vena vena/superior vena cava right atriumright ventriclepulmonary
artery(lungs) to exchange deoxgynated blood to oxygenated bloodpulmonary
veinleft atriumleft ventricleaorta and out to the systemic area
 Left side of the heart has more pressure
Child with cardiac defects  failure to thrive
 They are burning calories while they are “sucking” and drinking milk or formula, feeding
makes them work harder
 They need to be given a high calorie formula (fortified)
 Gavage-feeding: if they don’t finish their bottle you give the rest though OG or NG tube
to ensure they get all the food necessary to grow
 Frequent rest periods
 Small frequent meals (15 min each breast)
3. Assessment of a child after cardiac catheterization-
 Keep the legs straight and put pressure on the site
4. Bacterial infection can cause valvular issues
5. Babies that don’t feed well give higher calorie formula to the baby. Because
they use calories trying to eat. Not necessarily small frequent meals but more of higher
calorie formulas.
6. Acyanotic episode- nursing intervention
 Knees to chest
 hyper cyanosis- Put them in a knee check position. It has to do with the
pressure changes to help the circulatory system them you can worry about
oxygen. Blood gets thicker Polycythemia cyanotic
Digoxin Safety:
o Effects of Digoxin Therapy
o What it does:
 Slows HR and Increases contractility of the heart to pump blood systemically and more
effectively
o Safety
 Double check dosage with second RN (rarely more than 1 mL)
 Mark on calendar
 Give on empty stomach
 Clean teeth after administration
o How do you know if it works?
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Concepts Of Materna (NUR 4130) Peds Final - SG - Professor Lewis

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