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TMill
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What does Cyanosis mean?
Color?
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What does Pallor mean?
Color
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Normal capillary refill in children?
< 2 seconds
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What is seen in toddlers and older children as an unconscious attempt to relieve hypoxia, especially during activity?
Squatting
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What is clubbing related to?
Cyanosis
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After a cardiac cath, what is the nursing care that should be provided?
Affected Leg kept straight for 4-6 hours
HOB 20 or less
VS every 5-15 min - check distal pulses
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When should you notify doctor after a cardiac cath?
- Absent pulse
- Increased mottling
- Increasing pain
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If bleeding occurs from insertion site of catheter what should you do?
Hold pressure for 10-15 min
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Discharge instructions for someone go just have a cardiac cath?
No soaking in tub for first few days
No strenuous activity for 1 week
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When should you not give digoxin to an infant?
- If pulse rate below <100
- (count apical pulse)
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What are signs of digoxin toxicity in children?
- Nausea/vomiting
- Bradycardia
- Dysrthymias
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What should you teach parents about digoxin?
How to take pulse (hold if less than 100)
Give at same time each day
Call Doctor if child vomiting or lethargic
Keep locked in cabinet
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Interventions for excess fluid volume r/t Fluid Overload?
Give diuretics (Lasix or Spironolactone)
Asses edema, especially Periorbital
(fluid and sodium restriction usually not needed because children have a decreased appetite anyways)
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Interventions for Ineffective breathing pattern r/t pulmonary congestion?
- Monitor rate and rhythm
- HOB 30-45 degrees
- O2 as ordered
- Rest periods
- Prevent exposure to illness
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Interventions of imbalances nutrition?
- Small frequent meals
- Feed every 3 hrs
- Assess for dehydration
- Weigh daily
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What does the Foramen Ovale do?
Allows blood to flow from the right atrium to the left atrium
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What does the Ductus Arteriosis do?
Allows blood to flow from the pulmonary artery to the descending aorta
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What is Patent Ductus Arteriosis?
What do u hear to diagnose this?
Opening persists between the aorta and pulmonary artery
- Hear a continuous
- Machine like murmur
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Treatment for Patent Ductus Arteriosis?
Indocin or NSAID
Cardiac cath & surgery
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What is an abnormal opening between atria, (patent foramen ovale)?
Atrial Septal Defect - sometimes infants are asymptomatic but over time can develop fatigue & dyspnea and itwill be notived around middle age or later
may close on its own or need surgery
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What is the most common congenital cardiac lesion?
Ventricular Septal Defect
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Ventricular Septal Defect?
Abnormal openin between ventricles
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If your patient measures with different BPs and pulses in the upper and lower extremities what should you expect?
Coarction of the Aorta
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What are the 4 defects of Tetralogy of Fallot?
- VSD
- Pulmonic Stenosis
- Overriding Aorta
- Right Ventricular Hypertrophy
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Tet spells are common with Tetraology of Fallot and considered to be an emergency, what interventions should you do?
- Place infant in the KNEE-CHEST position
- Calm infant
- 100% oxygen
- Morphine
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What are common causes or Infective Carditis?
Stap or Strep
Dental work may increase your risk! UTI or Cardiac surgery as well
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What should children do before any invasive procedure that have a history of endocarditis?
Prophylactic Amoxicillin orally 1 hr prior
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What is the drug of choice for Rheumatic Fever?
PNC
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What are the major clinical manifestations of Rheumatic Fever?
- Carditis
- Polyarthritis
- Chorea
- Sub-Q nodules
- Rash
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What are the minor clinical mnifestations of Rheumatic Fever?
- Fever
- Arthalgia
- Prolonged P-R interval
- Elevated ESR or + CRP
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Qualifications of being diagnosed with Rheumatic Fever?
Must have 2 major or 1 major/2 minor manifestations and evidence of a recent strep throat infection
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Treatment for Kawasaki Disease?
IV gamma globulin & Aspirin within 10 days of fever onset
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Treatment for secondary hypertension?
treat underlying disease
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Treatment for primary hypertension?
Weight reduction, physical conditioning, dietary modification, relaxation techniques, meds, no tobacco
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