Signs & Symptoms
A pink baby with mild fast breathing and sweating during feeds likely has what type of CHD?
Acyanotic
Normal SpO2 goal for most acyanotic CHD patients is above what number?
92%
I&Os and daily weights.
T or F: Oxygen is always safe in every CHD patient
False
What position helps during a Tet spell?
Knee-to-chest
Blue lips and nail beds are called what?
Cyanosis
Most cyanotic CHD patients have a normal baseline SpO2 around what range?
75-85%
Why is fluid overload dangerous in CHD?
Worsens heart failure and lung congestion
When is oxygen safe to give?
CHD in respiratory distress and maintaining SpO2 below their baseline
What environment helps calm a Tet spell?
Name one sign of poor feeding in CHD babies.
Sweating with feeds/fatigue/poor weight gain
Why is it important to know a CHD patient's baseline SpO2?
So, you know what is normal for them and whether supplemental oxygen is needed or not.
Name one sign of dehydration in a CHD patient.
Dry mucous membranes/decreased urine output/hypotension
Why can oxygen be dangerous in ductal-dependent CHD?
It can close the ductus arteriosus
What type of oxygen is used during a Tet spell?
Blow-by oxygen
What physical change can happen in long-term cyanotic CHD?
Clubbing of fingers/toes
Cool hands and slow cap refill mean what problem?
Poor perfusion
Why is dehydration risky in cyanotic CHD?
Blood becomes thicker and makes it harder for heart to pump.
A cyanotic patient is at SpO2 80%. Emergency?
No. That is most likely their baseline.
Name one medication often used during a Tet spell and why it works.
Morphine helps a Tet spell by relaxing blood vessels and calming the patient, which sends more blood to the lungs instead of around them and improves oxygen levels.
A child who squats when tired is showing a classic sign of what condition?
Tetralogy of Fallot
What abdominal finding suggests fluid overload in CHD?
Hepatomegaly
What's one nursing action to prevent fluid overload?
Follow fluid restrictions/assess for edema and/or crackles
What rule must you follow before giving oxygen in CHD?
Know the diagnosis and baseline SpO2.
What is the main physiologic problem happening during a Tet spell?
Increased right-to-left shunting, which sends less blood to the lungs and causes severe hypoxia.