Infant
Sensorimotor
S/S of left side heart failure
Pulmonary edema, crackles, orthopnea, tachycardia, tachypnea, fatigue
S/S Right heart failure
Periorbital edema, tachycardia, ascites, enlarged liver, weight gain, edema
Will keep ductus arteriosus open
Alprostadil
First line of treatment for Tetralogy of Fallot
Propranolol. Decreases heart workload.
Toddler
Autonomy v Shame and doubt
Sensorimotor and preoperational
Digoxin
HR 100-160 for infant, 70 for child
Toxicity over 2.0
Obstructive disorders
Coarctation of the aorta
Aortic stenosis
Pulmonary stenosis
Neonate: 3.7-5.9
Infants: 4.1-5.3
Children 3.4-4.7
*this was pulled from Lippincott advisor
Common Increased pulmonary blood flow S/S
Difficulty breathing, grunting during feeding, murmur, frequent respiratory/lung infections, poor weight gain
Preschooler
Initiative v guilt
Preoperational
Disorders that decrease pulmonary blood flow
Tetralogy of Fallot
Tricuspid atresia
What causes poor feeding?
Heart fails to pump blood forward, causing fluid to back up into lungs.
Loud machine like murmur
Patent ductus arteriosus
School aged
Industry v inferiority
Concrete operational
Disorders that increase pulmonary blood flow
VSD
ASD
PDA
Risk factors
Down syndrome
Infection, ETOH, drug use during pregnancy
Polycythemia
Increased blood volume and viscosity
Blood clot risk
BP high in upper extremities, low in lower extremities
Coarctation of the aorta
Adolescent
Identity v role confusion
Formal operations
Mixed defects
Transposition of the great vessels
Truncus arteriosus
Hypoplastic left heart syndrome
Will close the ductus arteriosus
Indomethacin
Helps pressure build up
Interventions
Small frequent feedings