Respiratory
List 3 signs of respiratory distress
Hypoxemia, coughing, retractions, cyanosis, unable to speak in complete sentences
List 3 symptoms of heart failure
Orthopnea, tachycardia, fatigue, decreased BP, difficulty feeding, diaphoretic, weak, pale, wt gain, decreased urine output, nasal flaring
Symptoms of bacterial endocarditis and what would you tell a parent to do for a child that presents with these symptoms
Decreased po, fever, muscle and joint pain
Bring child in immediately
Benefits of an RBC transfusion in a child with anemia
increased energy, improved oxygenation, improved color
List 3 orders you will anticipate for a child that presents with respiratory distress
Continuous pulse ox, labs, viral swab, oxygen, RT consult, nebulizer treatments
How will you explain to parents why sedation is needed in their child that has poor cardiac function?
The heart needs to rest and sedation will help your baby stay calm
List 3 signs or symptoms of Kawasaki disease
Red palms/soles, strawberry tongue, lymphadenopathy, fever, fatigue, peeling skin, rash, red eyes
What is the number one cause of iron deficiency anemia in toddlers?
Cow's milk, it is not a good source of iron for this age group
List 3 findings that you will see in a child whose respiratory condition is improving
Oxygenation, increased oral intake, increased LOC, improved blood pressure
What nutritional adjustments need to be made for a baby in heart failure?
Increased calories
What should you teach families of a child with kawasaki disease regarding vaccinations?
Avoid any live virus vaccines for 11 months
What product can you anticipate to be ordered prior to procedures for a hemophilia A child?
Recombinant
At what age can you anticipate a child with pneumonia to be diagnosed with mycoplasma pneumonia?
5 yrs old and up
Priority action when Digoxin is due and child is vomiting
Hold med and notify provider
List 2 causes of acquired cardiac defects
infection, autoimmune, familial, environmental
What is the priority teaching you would give to a family with a child that has acquired immunodeficiency syndrome?
Infection control and prevention
What is the term used for the "common cold"?
Nasopharyngitis
Digoxin should be withheld for an apical heart rate of below what in an infant and what in a child?
Infant 90
Child 70
What is the most common cardiac anomaly?
VSD
List 2 priority actions you would take for a hemophiliac child post tonsillectomy
Watch for increased swallowing, ensure there is factor VIII available, assess for bleeding
Name one condition that a child with strep pharyngitis is at risk for if untreated
Acute rheumatic fever, acute glomerulonephritis, scarlet fever
Priority action for a child with active bleeding at the site after a cardiac cath
Apply direct pressure above the insertion site
What kind of diet can you anticipate a child with CHD be on?
High protein
Symptoms of acute chest syndrome in sickle cell anemia
chest pain, fever, cough, tachypnea, wheezing, and hypoxia
*emergent
Number the drug of choice (pending no allergies) prescribed for a child with strep pharyngitis
PCN
Clinical manifestation of coarctation of the aorta
increased BP in the arms with decreased BP in the legs
What does the term "innocent murmur" mean?
normal cardiac anatomy and cardiac function
Ineffective tissue perfusion r/t thrombosis can be a consequence of what disorder?
Acute vaso-occlusive crisis
What is the primary etiology of mononucleosis?
EBV
Heart defect that results in decreased pulmonary blood flow AND cyanosis in a newborn
Tetralogy of Fallot
If a murmur is grade 4, what does this indicate?
loud murmur with a palpable thrill
What medication should be included for a sickle cell child who is in MILD pain?
Tylenol
Which organ is primarily impacted in a child with mononucleosis and prevents the child from participating in contact sports?
spleen
How would you describe the pulmonary blood flow in a child with a patent ductus arteriosus?
Increased pulmonary flow
Name 2 defects that are considered "obstructive"
coarctation of the aorta, aortic stenosis, pulmonic stenosis
What is the number one intervention to prevent sickle cell crisis?
Hydration
What will you instruct parents on when an antiviral can be given to their child who has flu like symptoms?
Must be given within the first 48 hours of symptoms
In a newborn with cyanotic heart disease what nursing actions should be included in POC?
I/O, keep calm, cluster care, monitor VS
When should you notify the surgeon regarding your patient's chest tube output?
Notify surgeon if chest tube drainage greater than 3 ml/kg/hr × 3 consecutive hours OR 5 to 10 ml/kg in any 1 hr
What medication is used for iron overload as a consequence of frequent blood transfusions?
Deferoxamine
Name 2 interventions that can help prevent ear infections
Breastfeeding, bottle feed upright (no bottle prop), no second hand smoke exposure, PCV vaccine
Prostaglandin is ordered until surgical correction. How will this be administered
Continuous infusion until surgery is completed
List 3 symptoms of cardiac tamponade
tachycardia, hypotension, tachypnea, JVD, feeling of panic, decreased LOC
What is the inheritance percentage of a couple having a child with sickle cell disease?
There is a 25% chance of having a child with sickle cell
Otitis externa is also known as....
swimmers ear
List the cyanotic heart defects
Tetralogy of Fallot, Truncus arteriosus, Transposition of great vessels, Tricuspid atresia
List 3 symptoms of Postpericardiotomy Syndrome
fever, WBCs, pericardial friction rub, pericardial, and pleural effusion
List 3 symptoms you will see in a child with anemia
poor feeding, tachycardia, tachypnea, FTT, pale, weak
Name 3 signs or symptoms you will see in a child with epiglottitis
Abrupt onset, Sore throat, pain, tripod positioning, retractions ,Inspiratory stridor, mild hypoxia, distress,
Fever
What defects are included in Tetralogy of Fallot?
VSD, Aorta enlargement, Pulmonary stenosis, Right ventricle hypertorphy
What is the purpose of digoxin?
Improves contractility
Which type of thalassemia is considered "silent" due to the fact that the child is usually asymptomatic?
Thalassemia minor
What is the purpose of the spacer that is used with MDI treatments?
increases the amount of medication delivered to the lungs
What is the purpose of the ductus arteriosus?
lets blood bypass the lungs
Treatment of Kawasaki disease
IVIG, high dose aspirin
What labs can you expect to find in a child in DIC? (name 2)
Decreased platelets, prolonged PT/PTT, decreased fibrinogen