Prolongs action potential duration raises VFib threshold, vasodilator Adenosine Treat SVT – slows heart rate o Actions: Code Nurse Med nurse Documentation nurse Compressor Respirations Cart/Defib nurse Clerk Other nurses on unit Pediatric Rhythms Rhythm Treatment Normal sinus rhythm NOTHING Sinus Bradycardia Atropine, breaths, CPR, pacing, nothing Sinus Tach Treat the cause Asystole CPR, Epi o Review cardiac rhythms at: Cardiac Rhythms o Peds Arrhythmias Rhythm Treatment Supraventricular Tachycardia (SVT) Vagal maneuvers, ADENSOINE, synchronized cardioversion
Wolff-Parkinson-White (WPW) Same as SVT (if in SVT), B & Ca+ Channel blockers, Ablation Long Q-T Syndrome B-blocker, ICD, Pacemaker Ventricular Tachycardia CPR, Defib, Epi, Vasopression, Amiodarone, Lidocaine Premature Ventricular Contractions (PVCs) Nothing Complete Heart Block Pacemaker o **SVT = most common in peds Vagal – if kid can blow through a straw. For baby – hold ice in bag on face (will cause baby to hold breath and bare down) ADENOSINE – chemical STOP & RESTART of heart (will flat line) o WPW – Extra pathway of heart (delta wave) QRS slow upward then quickly o *Think long Q-T wave causes SIDS* - syncope episodes, increased risk for torsade’s o ICD – intra cardial defib (like a pace maker) Child’s experience in PICU o Pain o Sleep disruption o Stress Developmental level Past experiences Type of illness Coping mechanisms Available emotional support Child PTSD risk factors o Severity of illness o Invasive procedures o Restricted to bed o Attached to equipment o Sedation and analgesia Coping o Regression o Denial o Repression o Postponement o Bargaining Helping children cope o Promote sense of control o Facilitate use of play o Encourage routines o Encourage privacy o Diversion Parent stressors o Loss of parenting role Encourage to do what they can do o Risk for PTSD o Cannot support child if their own needs are not met Family crisis o Accumulation of stressors o Coping skills insufficient or ineffective o Use of maladaptive coping skills o Change in parent-child relationship and interactions Parent reactions o Shock and disbelief o Anger and guilt – feel like they could have done something different (or blame other parent) o Deprivation and loss o Anticipatory waiting o Readjustment or mourning Family interventions o Build trust o Accurate information May need to present in stages (even if we know from get-go that child wont survive) o Prepare for first view of child Tell the parents exactly what they are about to see o Family presence during resuscitation or invasive procedures Respite for Parents o McDonald house o Encourage to take breaks o Encourage family assistance o Support limits for family o Encourage routines Chronic Conditions o Chronic – lasting at least 3 months
Ongoing Adaptation to daily living May or may not be terminal Types o Genetic conditions
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- Spring '17
- Mucus, pain scale