Pediatrics - Alterations In Cardiovascular Function Part I

A cyanotic lesion refers to a condition where there is a lack of oxygen in the blood, resulting in a bluish discoloration of the skin and mucous membranes. This indicates a serious underlying problem with the child's cardiovascular system. Surgical intervention is often necessary to correct the issue and improve blood flow and oxygenation. Therefore, the statement that a child with a cyanotic lesion needs surgical intervention is true.

Furosemide, also known as Lasix, is the diuretic of choice for acute, severe congestive heart failure (CHF). It helps to remove excess fluid from the body by excreting sodium, chloride, and water. However, it can also deplete potassium levels in the body. Therefore, when administering Furosemide, healthcare professionals should monitor for signs and symptoms of digoxin toxicity, which can occur due to low potassium levels.

Digoxin, also known as Lanoxin, is included in the plan of treatment for a CHF (Congestive Heart Failure) client because it increases contractility of the heart. Digoxin works by inhibiting the sodium-potassium ATPase pump, which leads to an increase in intracellular calcium levels. This increase in calcium enhances the contractility of the heart muscle, improving cardiac output and reducing symptoms of CHF. Therefore, Digoxin is a commonly used medication in the treatment of CHF to help improve the heart's pumping ability.

Cyanotic lesions are characterized by a right to left shunting of blood, meaning that deoxygenated blood bypasses the lungs and enters the systemic circulation. This leads to a decrease in pulmonary blood flow, as less blood is being oxygenated in the lungs. Therefore, the correct answer is "Decreased."

The statement "I love seafood - shrimp mainly. However, I've had an awful allergic reaction to shellfish before" would require further investigation and may delay or cancel the procedure because the client has a known allergy to shellfish. Since the cardiac catheterization procedure involves the use of contrast dye, which can contain shellfish proteins, there is a risk of an allergic reaction during the procedure. Further investigation is needed to assess the severity of the allergy and determine if any precautions or alternative options are necessary to ensure the safety of the client during the procedure.

This answer suggests that the given lesion is an acyanotic lesion. Acyanotic lesions are characterized by normal oxygen levels in the blood, which means that there is no cyanosis (bluish discoloration of the skin). The explanation also mentions that with this type of lesion, there is an increase in pulmonary blood flow with left to right shunting. This typically occurs during infancy or early childhood.

Left-sided heart failure occurs when the left side of the heart is unable to efficiently pump blood to the rest of the body. This leads to a buildup of blood in the lungs, causing increased pulmonary pressure and pulmonary edema. The congested lungs result in symptoms such as shortness of breath, coughing, wheezing, and fluid retention. In contrast, right-sided heart failure primarily affects the right side of the heart and causes fluid buildup in the body's tissues, leading to symptoms such as swelling in the legs and abdomen. Therefore, the correct answer is left-sided heart failure.

Right-sided heart failure refers to the inability of the right side of the heart to effectively pump blood to the lungs for oxygenation. This can lead to a decreased amount of blood being oxygenated by the lungs. Symptoms of right-sided heart failure may include fluid retention, swelling in the legs and abdomen, and fatigue. Left-sided heart failure, on the other hand, refers to the inability of the left side of the heart to effectively pump blood to the rest of the body. Its clinical manifestations are different from those of right-sided heart failure.

In congestive heart disease, the heart is unable to pump blood effectively, leading to a decrease in blood flow throughout the body. This can result in diminished pulses, as the weakened heart is unable to generate a strong pulse. Therefore, it is expected to note diminished pulses in a child with congestive heart disease, along with peripheral edema.

Jugular vein distension-older children

Oranges and orange juice
Bananas
Legumes
Raisins, prunes, dates
Potatoes
Apricots, peaches
Tomato juice

In congestive heart disease, the heart is unable to pump blood effectively, leading to poor circulation and inadequate oxygenation of tissues. This can result in decreased appetite and difficulty in feeding, causing poor weight gain in the child. Additionally, the increased workload on the heart can lead to increased energy expenditure, further contributing to poor weight gain. Therefore, it is expected that the child with congestive heart disease will have poor weight gain.

Following a cardiac catheterization with angiocardiogram procedure, it is important for the nurse to apply direct pressure to the catheterization site for 15 minutes. This is necessary to ensure that any bleeding from the site is controlled and to prevent the formation of hematoma. After the direct pressure is applied, a pressure dressing should be applied for 6 hours. This helps to maintain pressure on the site and further prevent bleeding or hematoma formation.

If missed dose is more than 4 hours late then do not give that dose

Obstructed systemic blood flow can lead to decreased blood supply to the peripheral tissues. This can result in diminished pulses, as the blood flow to the extremities is reduced. Delayed capillary refill is also seen, as the blood takes longer to reach the capillaries and refill them. Coarctation of the aorta is a congenital heart defect that can cause obstruction to blood flow, leading to these manifestations. Ventricular septal defect, on the other hand, is a communication between the ventricles and does not directly cause obstructed systemic blood flow. Increased urine output is not typically seen with obstructed systemic blood flow, as decreased blood supply to the kidneys would lead to decreased urine production.

Position semi-fowler's (45 degrees)
Small, frequent feedings
Burp every 1 - 2 ounces
Limit feedings to 20-30 minutes
Alternate oral and tube feedings
Weigh daily
report gain > 50 g/day

Digoxin, a medication used to treat congestive heart failure (CHF), can cause increased force of contraction, decreased heart rate, and increased renal perfusion. However, it is not recommended for use in children younger than one month old. This is likely due to the fact that infants in this age range may have immature organ systems, including the heart and kidneys, which could potentially be more susceptible to the effects of the medication. Therefore, it is important to avoid using digoxin in children younger than one month to prevent any potential harm.

In children and young infants, both the right and left sides of the heart can fail simultaneously. This is because the heart is still developing and may not be able to function properly. When both sides of the heart fail, it can lead to serious health complications and may require medical intervention.

If a client shows signs of mixed defects such as cyanosis, poor weight gain, pulmonary congestion, and CHF, the cardiac defect that would be expected is Transposition of the Great Arteries (TGA). TGA is a congenital heart defect where the two main arteries, the pulmonary artery and the aorta, are switched in position. This results in deoxygenated blood being pumped back to the body and oxygenated blood being circulated back to the lungs, leading to cyanosis and poor oxygenation of the body. The symptoms of poor weight gain, pulmonary congestion, and CHF are also commonly associated with TGA.

When auscultating a child with Congestive Heart Disease, it is expected to hear murmurs. This is because murmurs are abnormal sounds that are caused by turbulent blood flow through the heart. Additionally, fluid in the lungs is expected in Congestive Heart Disease as the heart's inability to pump blood effectively can lead to fluid accumulation in the lungs. Tachypnea, or rapid breathing, is also expected as the body tries to compensate for the decreased oxygenation caused by the heart's inefficiency. Diminished breath sounds, however, are not typically associated with Congestive Heart Disease and would not be expected.

Increased pulmonary blood flow refers to a condition where there is an abnormal increase in the volume of blood flowing through the pulmonary circulation. This can occur due to congenital heart defects or conditions such as left-to-right shunts. Tachypnea, or rapid breathing, is seen as the body tries to compensate for the increased blood flow. Frequent respiratory infections may occur due to the increased workload on the lungs. Diaphoresis, or excessive sweating, can also be a manifestation of increased pulmonary blood flow. Cyanosis, a bluish discoloration of the skin, and polycythemia, an increased number of red blood cells, are not typically seen with increased pulmonary blood flow.

Check apical pulse for one full minute
- hold if HR - hold if HR - hold if HR