All chd conditions but asd require prophylaxis prior

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leading to death. All CHD conditions but ASD require prophylaxis prior to procedures. Rheumatic Fever Acute fever that is result of Group A beta hemolytic strep onset that occurs about 2-3 weeks after infection. Patient doesn’t take antibiotic correctly. S+S: carditis, arthritis, pink rash with round margins & clear center that feels like sandpaper, fever, chorea (can’t walk) Labs: increased sedimentation rate, increased C reactive protein, sometimes has a positive strep culture Tx: rest, steroids to decrease inflammation, antibiotics, follow up ECG, sometimes aspirin is used so embolisms don’t form Kawasaki Disease A mucocutaneous lymph node disease characterized by fever, rash, peeling hands & feet, swollen lymph nodes, strawberry tongue, red/pink eyes. 1/5 children develop coronary artery weakness, which can cause thrombus in coronary artery so must follow for 1-2 years. Caused by relovirus or richettsiae d/t dust mites in carpet, which children are close to. Often misdiagnosed by primary care physician as hand foot & mouth, pink eye, or strep. Tx: IVIG immunoglobulin infusions then aspirin therapy to decrease risk of thrombus, follow up ECGs Marfan Syndrome Genetic disorder of the connective tissue that causes orthopedic, optical, & cardiovascular problems. The major problem is weakened aortic wall due to elongation. Also has oversized aortic valves & MVP. S+S: Pigeon chest & mitral valve prolapse, genetic testing Tx: no contact sports, beta-blockers, therapy decreases stress on vessel so size doesn’t increase. If patient has any chest pain tell patient to go to ER in case aorta dissected, ruptured, or dilated (must have mesh placed & be flown out) Wolf Parkinson White (WPW) Conduction pathway that gives signal too soon, short cut from normal traveling of signal down the AV node, which causes a rapid heart rate or life-threatening rhythms (SVT/VT). Abnormal firing causes ventricular tachycardia (all large waves), ventricular fibrillation (all small waves), Torsade des pointes waves (big teeth, little teeth) Tx: beta blockers to prevent outbreaks, ablation (burn off abnormal pathway) Prolonged QT Syndrome Hereditary disorder of the heart’s electrical rhythm, which fires at an abnormal site. QT interval becomes elongated and this can lead to a rapid heart rate like Torsade des pointes, which can lead to Vfib and death.
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Tx: anti-arrhythmic medication to prevent life-threatening outbreaks, can defibrillate to put back in correct rhythm. Hematological Alterations in Children Normal Blood Counts Bone marrow produces WBCs, RBCs (carry O2), and platelets (internal bleeding, nose bleeds) BLOOD PRODUCT NORMAL Hgb 11-13 Hct 32-40% WBC 5-11 Platelets Above 150,000 (202-403) Terms: Low WBC= risk for infection Low platelets= risk for bleeding/injury Polycythemia- too many RBCs Leukocytosis- too many WBCs due to infection Leukopenia/neutropenia- too few WBCs, have some infection that needs to be fought off.
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  • Winter '19
  • Melissa DuVall

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