Cardio dysfx
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| CHF is? | heart failing to meet needs of body.
s/s: tachy, fatigue, weakness, restlessness, pale, cool extremities, decr bp/urinary outputq
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| s/s pulmonary congestion assoc with CHF | tachy, dyspnea, resp distress, excercise intolerance(not infants), cyanosis....back up from L side, pul htn
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| s/s systemic venous congestion assoc with CHF | peripheral edema, wt gain, ascites, hepatomegaly, neck vein disention..back up from R side, syst venous htn
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| two causes for CHF | 1.overcirculation failure: blood mixes inside heart
2. pump failure: heart muscle becomes damaged, not contract
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| how is heart failure id by parents in infants? | inf: poor feeding, breathing prob, poor growth, feel bounding pulse
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| Mgmt for CHF? meds? | mgmt: remove fluid/Na, decr cardiac demands, improve tissue O2, decr O2 consumption
med: Lanoxin(dig)..lowers HR, makes pump harder, check HR for 1m, hold <90 for infant, 70 in child, not receive more than 1ml dose, if >4ml, check math
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| s/s dig toxicity | N/V, anorexia, brady, dysrhythmias
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| ACE inhibitors | vasodilate so decr pul/sys resistance, decr bp, reduce afterload, "prils", take bp b4/after
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| diruetics | Lasix, maybe fluid/Na restrict in diet, but most kids need to drink more water
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| Decr cardiac demands how? | limit physical activity, keep warm, treat inf, elevate head, smaller more freq meals, sedate, stop crying,
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| maintain nutritional needs for CHF | greater caloric needs, gavage feedings, promote fluid loss, measure I/O
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| Hypoxemia | less than normal O2 sat 80-85%, cyanotic, can cause polycythemia and cause body to build more blood cause decr O2, so viscous blood, anemia, eisenmenger complex
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| s/s hypoxemia | polycythemia, clubbing, squatting with TET, hypercyanotic spells
tx: morphine to decr O2 demand
nsg: watch for fever/inf(endocarditis), prevent dehydration(worsen polycythemia)
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| Prepare family/child for surgery | post op: VS, hypothermic, suction, chest tube drainage(>3ml for more than 3h or >5ml for 1h call dr
renal failure if <1ml/kg/hr w/ elevated BUN/creatinine
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| Infectious/inflammatory cardiac disorders | Endocarditis: inf valves/endocardium
cause:strep/staph/fungal inf
prophylaxis: 1h b4 procedure
tx: antbx, amphtericin B
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| Rheumatic Fever | inflammatory disease after Group A B hemolytic strep, affects joints,skin,brain
carditis: in mitral vavle
arthritis, rash, subq nodules, aschoff bodies
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| St. Vitus Dance 5th manifestation | symptom of RF, chorea: sudden aimless mvmts of extremities, involuntary, facial grimaces
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| Prevent RHD, rheumatic heart disease | treat strep with penicillin, sulfa, erythromycin
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| Two types of heart transplants | orthotopic, heterotopic(piggyback)....rejection is issue
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| sytemic hypertension | primary: no known cause
secondary: id cause
tx: treat cause
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| Kawasaki Disease | fever 105 for 5 days, rash in groin area, painful joints, red eyes, strawberry tongue, puffy hands/feet with peeling
tx: IVIG, aspirin
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| types of shock: anaphylaxis septic(systemic inflammatory response syndrome) toxic shock | anaphylaxis: allergen sensitivity
s/s: resp prob, uticaria(hives), LOC
Toxic: fever,chills, rash, desquamation on hands/feet
tx: antbx, take tampon out in 4-6h
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| septic shock | s/s vasodilation from fever so feel warm
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