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cv dysfunction

cv deviations (peds)

changes that occur from fetal circulation chaanges in hemodynamics, PDA closes, Foramen Ovale closes
differences seen in the CV system of an infant/child VS adult Rate, position of heart, BP
Concept to remember when assessing CV function ot the child least invasive to most invasive
defining characteristics of Increased pulmonoary Blood Flow defects increase amount of blood to the lungs,R ventricular hypertrophy, left to right shunt
clinical S/Sx of increased pulmonary blood flow tachypnea, tachcardia, increase KCAL needs, increase metabolic needs, FTT,poor suck, Na+ and fluid retention
Examples of increase pulmonary blood flow defects PDA,ASD,VSD
defining characteristics of disorders of decreased pulmonary blood flow some obstacle of BF to lungs, pressure in R side increases, right to left shunt, deO2 blood pumped to tissues
clinical S/Sx of decreasesd pulmonary blood flow mild to severe desat, oxygen saturation 50-90%, increase in erythropoietin, polcythemia
Examples of defects that result in decrease pulmonary blood flow tetralogy of Fallot,tricuspid atresia
defining characteristics of obstructive disorders involves some narrowing of a major vessel, causes increase workload of heart, periperal circulation or BF to lungs is affected
examples of obsturctive disorders Ooarctation of Aorta, aortic Stenosis,Pulmonic Stenosis
definig characteristics of mixed disorders complex anomalies that depend on the mising of blood from pulmonary and systemic circulation within the heart for survival
Examples of mixed defects Transposition of Great Vessels, Truncus Arteriosus,Hypoplastic Left Heart Syndrome
Acquired Cardiovascular Disorders disorders due to underlying cardiovascular problems or defects
congestive heart failure inablity of heart to pump adequeate amount of blood to systemic circulation at normal filling pressures to meet body's metabolic demands
Causes of CHF volume overload, pressure overload (from obstructive disorders), decrease contractility (cardiomyopathy), high cardiac output demands
Clinical S/Sx of CHF impaired myocardial function, pulmonary congestion, systemic venous congesiton
S/Sx of impaired myocardial function tachycardia, exercise intolerance, ittirable, poor perfusion, cold extremities, weak pulses, slow cap refill, low BP
S/Sx of pulmonary congestion tachypnea, hypoxemia, imparied gas exchanage, inabiloty to feed, poor weight gain, intercostal retractions, wheezing, increase KCAL needs, FTT,rales
S/Sx of systemic congestion pooling of blood in venous circuation, hepatomegaly, Na+ and fluid retention, weight gain, distended neck veins
Management of CHF improve caridac funciton, remomve accumulataed Na+ and fluid, decrease cardiac demands, improve tissue oxygenation, decrease oxygen consumption
ACE inhibitors inhibits conversion of angiotensin I to II. vasodilation then occurs. renal blood flow increases thus increase diuresis
digoxin increase force of contraction(positive inotropic) decreases heart rate (neg chronotropic)
Lasix diuretic. monitor K+ levels. Fall in K+ enhances effects of digoxin
Infective (bacterial) endocarditis infection of vlaves and inner lining of heart. Sequela of bacteremia in children with congenital anomalies of the heart. areas of risk are those with turbulent BF
Clinical S/Sx of endocarditis new changes in heart sounds, splenomegaly, feeding diffculties, respiratory distress, tachycardia, CHF, splinter hemorrahges, Osler nodes, Janeway spots
Management of endocarditis high dose PCN, PRIMARY PREVENTION IS THE KEY, may use prophylatice antibx 1 hr before invasive proceedure
Rheumatic Fever inflammatory disease that occurs after group Astrep pharyngitis. involves jounts, skin, brain, heart inflamed heomrhagic lessions are formed
Management of Rheumatic Fever eradication of strep infection, prevention of permanent cardiac damage
Treatment for Rheumatic Fever PCN, salicylates, prednisone may be used short term
Kawasaki Disease acute systemic vasculitis of unknown cause. wide spread inflammataion of small and meduim vessels. can lead to aneruysms or infarction
clinical S/Sx of Kawasaki disease high fever, conjunctivae become red, inflammation of pharynx, red/cracked lips, strawbery tongue, rash-may desquamate, VERY ITTITABLE
Management of Kawasaki disease high dose of IVIG, salilcylate therapy, anticoagulatory therapy may be needed
Beta Blockers block Beta receptor sites (decrease HR, dialate blood vessels, increase perfusion to kidneys)
Hypertension S/Sx frequent HA, vertigo, changes in vision, gross behavioral changes
Mangement of HTN dietary practaies and lifestyle changes, evalutae weight, use of salt, aerobic exercise, ACE inhibitors, Beta blockers
nursing interventions to promote adequate KCAL supply for infant with cardiovascular dysfunction group nursing care, allow for periods of rest, encourage small/frequent feedings, use of formula with increase KCAL content
PRIMARY PREVENTION to prevent complications of associated with rheumatic fever completion of antibx for strep throat
indomethocin Prostoglandin inhibitor. Encourages PDA to close
Prostoglandin E Encourages PDA to remain open
Created by: NURS390