List 2 defects that can cause increased pulmonary blood flow by shunting blood from left to right.
VSD & PDA
When does this disorder usually occur?
Within 2-6 weeks after an untreated or partially untreated URI w/ GABHS.
How does Iron affect Hgb levels?
Low iron = low Hgb because iron is needed to create Hgb
What kind of inheritance is sickle cell and who does it primarily affect?
Autosomal recessive and African Americans
Which type is "classic" and which is "Christmas"?
Classic - A
Christmas - B
What 2 defects cause a decreased pulmonary flow that make the children look blue.
Tricuspid Atresia and Tetralogy of Fallot
What are some expected findings?
Fever, tachycardia, cardiomegaly, new/changed murmur, friction rub, chest pain, nontender SC nodules over boney areas, polyarthritis, pink nonpruritic rash, and chorea.
List some expected findings.
Tachycardia, pallor, brittle nails, fatigue, systolic murmur, pica
What labs are elevated during a sickle-cell crisis?
WBC, bilirubin, & reticulocyte ct.
What are some expected findings for a patient with hemophilia?
A patient presents with upper extremities having high BP and bounding pulses while their lower extremities are cool and have a low BP. Their femoral pulses are absent. What CHD is this?
Coarctation of the Aorta
What is the number one education topic for this disorder.
Prevent it!!! Medication adherence!!
What method do you use when giving IM Iron injections?
Z-track
What are the 2 life threatening complications for sickle cell?
Stroke and Acute Chest Syndrome
List some appropriate sports for these patients.
Bowling, fishing, golf, and swimming.
What kind defects in CHD looks like HF?
Obstructive defects
What are the complications of Rheumatic Fever?
What are the complications of Kawasaki's?
Carditis, heart disease, Afib, & embolism
Coronary artery dilation & aneurysm formation
When should you give iron supplements to full term babies?
By 4-6 months old
What are some important interventions for these patients?
Emotional support, monitoring for crisis/infection, promoting rest and good nutrition, good hand hygiene, I&O's, stay UTD with immunizations, and avoid contact sports.
Should these patients use active or passive ROM exercises and why?
Active because passive is contraindicated due to risk of damage to joint capsules during acute attacks.
What is a Transposition of the Great Arteries and what must exist for blood to be oxygenated?
Where the aorta is connected to the R. Ventrical instead of the L and the pulmonary artery is connected to the left ventricle instead of the R.
A septal defect or PDA.
Does this patient have Kawasaki's or Rheumatic fever and what should your priority action be?
Patient comes in with CC: fever over last 5 days, rash covering trunk and inner thighs, ankles and feet red and swollen, joint pain, erythematous oral mucous membranes and eyes, and cervical lymphadenopathy.
Kawasaki's Disease
Get IV access and monitor VS & cardiac status
When doing discharge teaching for a patient with iron deficiency anemia, what should you include?
Give iron supplements 1 hr before or 2 hrs after milk, tea, or antacids. Use straw if its liquid. Take with vitamin C to increase absorption. Expect stool to turn green-black. Brush teeth after oral liquid to prevent staining.
What is a vaso-occlusive crisis and what does it look like?
A painful episode of sickle cell. Severe joint, bone, and abdomen pain, hematuria, obstructive jaundice, and visual disturbances.
What are some ways to manage and prevent bleeding while in the hospital?
Use SQ instead of IM. Avoid unnecessary skin punctures, use aseptic technique, monitor urine/stool/NG fluid for occult blood, no ASA. Control bleeding with factor replacement and pressure.