Nursing Exam 3 (Peds) Study
Guide
Cardiac
•Meds:
oLasix – I & O, K enriched foods
oDigoxin
▪Increases contractility, slows heart, dangerous drug with narrow window of safety.
▪Tale apical pulse X1min
▪If vomits, do not repeat dose
▪Dig Toxicity: Anorexia, nausea, vomiting, diarrhea, visual disturbances (Yellow vision<
bradycardia.
•Closely monitor for toxicity if on antibiotics
•CHF = Causes, S/S, nursing interventions, treatment
oS & S – Tachycardia, diaphoretic, weight gain, cardiac output decreased due to fluid overload
▪If on CHF, may require O2 during procedures
oCongenital defects: S/S, nursing interventions
oASD – may be asymptomatic but can develop CHF. Oxygenated blood flows back in the right
atrium. Usually with exercise intolerance. Diastolic murmur, risk for atrial dysrhythmias. Can
be treated with a surgical patch closure or cardiac cath can now be performed to dispatch a
closure device.
oCSD – Can cause hypertrophy of the right ventricle from the pressure from the lungs and the left
to right shunting. CHF is common, there is a loud holosystolic murmur.
oCoarctation of the aorta – Narrowing near the insertion of the ductus arteriosus which results
in increased pressure proximal to the defect (head and upper extremities) and decreased
pressure distal to the obstruction (Body and extremities). Patient presents with increased blood
pressure and bounding pulses in the arms, weak or absent femoral pulses and a cool lower
extremities with lower blood pressure.
oA cyanotic = oxygenated blood is not getting out to the systemic circulation, may go into the
lungs.
oTetralogy of Fallot: Four defects are ventricular septal defect, pulmonic stenosis, overriding
aortal and right ventricular hypertrophy. Manifestations are cyanotic at birth. It can start of mid
and progress with time. There is a systolic murmur, moderate in intensity. There can be acute
episodes of cyanosis and hypoxia call blue spells or you may see elevated HR and RR. When
these spells occur you will place the infant in the knee chest position. You will see older
children will automatically go into this position. Treatment is usually done within the first year
of life. Mortality is less then 3 percent. Congestive heart failure is a concern posturer.
•Rheumatic fever: Causes, s/s, nursing interventions, treatment.
oInflammatory disease occurs after group A
oB-hemolytic streptococcal pharyngitis
oTreatment of streptococcal tonsillitis / pharyngitis
