test 2 study guide PEDS (1).docx - 1 G&D\/Health promotion(Chapter 32\/33 a Toddler\/preschool b have an overall understanding of principles of growth and

test 2 study guide PEDS (1).docx - 1 G&D/Health...

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1. G&D/Health promotion (Chapter 32/33) a. Toddler/preschool b. have an overall understanding of principles of growth and development c. gross/fine motor development (milestones) d. review Piaget, Erikson – stages e. language development f. classifications and social aspects of play g. anticipatory guidance for common concerns: immunizations, nutrition, elimination, dental care, sleep, hygiene, safety, and play. h. toilet training during toddlerhood 2. Cardiovascular – chapter 42 a. TOF/Hypercyanotic spell /Tricuspid Atresia/chronic hypoxia consequences Hypercyanotic spell- hypoxic episodes that result in cyanosis due to a rapid drop in amount of oxygen in the blood; may be precipitated by crying, feeding, defecation, pain Chronic hypoxia consequences- heart failure and cyanosis b. VSD/ASD/PDA/coarctation of the aorta Atrial Septal Defect (ASD)- a “hole” in the wall that separates the top two chambers of the heart. Defect causes oxygen rich blood to leak into the oxygen poor blood chambers of the heart Ventricular Septal Defect (VSD)- hole in the wall septum separating the ventricles of the heart. It’s the most common defect at birth that lets blood shunt from the left ventricle to the right ventricle Patent Ductus Arteriosus (PDA)- abnormal blood flow occurs between two major arteries connected to the heart Large PDAs cause excess blood in the lungs and volume overload leading to Congestive Heart Failure Coarctation of the aorta- narrowing of the aorta (delivers oxygen rich blood to body) which results in the heart pumping harder to force blood through the narrowed part of the aorta c. Pulmonary Hypertension d. Congested heart failure manifestations & care/fluid volume excess/decrease CO/ineffective breathing/nutrition Congestive Heart Failure-inability of the heart to pump an adequate amount of blood into the systemic circulation Clinical Manifestations o Impaired myocardial function o Pulmonary congestion o Systemic venous congestion Manifestations o Difficulty feeding, poor weight gain o Mild tachypnea, tachycardia o Galloping rhythm o Shortness of breath o Cardiomegaly
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o Poor perfusion, edema o Liver/spleen enlargement o Mottling, cyanosis, pallor Management o Reduce workload of the heart and increase cardiac output o Monitor afterload reduction o Decrease cardia demands and reduce respiratory distress o Maintain nutritional status and assist in measures to promote fluid loss o Support child and family e. Care of the child with congenital heart defect i. Feedings o Feed the infant or child in a relaxed environment; frequent small feedings may be less tiring (every three hour feeding schedule); if child cannot consume appropriate amount nasogastric feeding might be considered o Hold the infant in an upright position. This may provide less stomach compression and improve respiratory effort o Monitor for increased tachypnea, diaphoresis, vomiting f. Cardiac catheterization post care/assessment o Specialized procedure in which a long flexible tube is inserted into a blood vessel and
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