Cardiac Lecture Nursing Care of the Child With a Cardiovascular Disorder The “NORMAL” Healthy Heart Cardiac Auscultation Cardiac Circulation Heart Murmurs – “Innocent” is not a problem. Classification of CHD Acyanotic Increased Pulmonary Blood Flow (ASD, VSD, PDA) Obstructive defects (COA, PS) Cyanotic Mixed blood flow (TGA) Decreased Pulmonary blood Flow (TOF) CYANOTIC Tetrology of Fallot (TOF) Transposition of the greater arteries (TGA) ACYANOTIC Atrial Septal Defect (ASD) Ventricular Septal Defect (VSD) Patent Ductus Arteriosus (PDA) Coarctation of the Aorta (COA) Atrial Septal Defect (ASD) Repair of ASD VSD- Ventricular Septal Defect Ventricular Septal Defect Nursing intervention (VSD) Assessment of the child with a significant VSD Medical treatment of a child with a VSD Surgical repair of VSD COA - Coarctation of the Aorta Coarctation of the Aorta (COA) Degree of COA Repair of COA PDA: Patent Ductus Arteriosus Patent Ductus Arterious (PDA) PDA (patent ductus arterious) closure
Tetrology of Fallot- TOF Tetrology of Fallot has: Four defects Pulmonic valve stenosis (PS) Right Ventricular Hypertrophy: right ventricle wall is large and thick. (RVH) Ventricular Septal Defect (VSD) Overriding Aorta (extends down to the level of the VSD) TOF Right to Left shunt. TET (hypercyanotic ) Spell Treatment for TET spell Put child in knee chest position to increase blood flow to upper extremities Administration of oxygen IV Administration of Morphine sulfate Knee-chest position for TET spell Treatment of TOF TOF complete repair Transposition of the greater arteries/vessels (TGA) Treatment (at birth) for TGA Surgical treatment for TGA Arterial Switch for TGA *Types of CHD Repair Open heart procedure : Closed heart procedure Cardiopulmonary bypass PGE 1/ Prostaglandin E 1/ Alprostadil Dosage: 0.05 - 0.1mcg/kg/min INDOMETHICIN (Prostaglandin Inhibitor) 1 st dose: 0.2mg - 0.25mg/kg/IV , three doses given at 12- 24 hour intervals until duct is closed. If Indomethacin fails to close duct, surgical intervention will be required. Acquired Cardiovascular Disorders of Childhood Acute Rheumatic Fever ETIOLOGY : PATHOLOGY:
Rheumatic Fever is classified by the Jones Criteria who are divided into major and minor criteria: Major criteria - RF Carditis – Polyarthritis Erythema marginatum – Subcutaneous nodules – Chorea (Sydenham’s disease) “St. Vitus Dance ”- * safety is a big issue- the younger the child the more danger Minor Criteria - RF Criteria for diagnosis of RF ( culture) Treatment and Nursing Care of RF : Prevention of RF *KAWASAKI’S SYNDROME ETIOLOGY/PATHOPHYSIOLOGY: Diagnostic Criteria for KS Kawasaki’s – Three phases of illness Acute phase : Sub acute phase : Convalescent phase : Neurologic Complications of KS Treatment during acute phase Nursing Considerations Family impact Kawasaki's syndrome * Bacterial Endocarditis
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- Spring '16