nursing care of the child with a cardiovascular disease clinical aspect of maternal and child...
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NURSING CARE OF THE CHILD WITH A CARDIOVASCULAR DISEASE
Clinical Aspect of Maternal and Child NursingNUR 363Lecture 9
ASSESSMENT OF HEART DISORDERS IN CHILDREN
• History
• Physical assessment– general
appearance– pulse, blood
pressure, & respirations
ASSESSMENT OF HEART DISORDERS IN CHILDREN
• Diagnostic tests– Electrocardiogram– Radiography– Echocardiography– Magnetic resonance imaging– Exercise testing– Laboratory tests
CLASIFICATION OF CHD
A Cyanotic Heart Defect Move blood from arterial …to…venous system
A Cyanotic
Increased in pulmonary blood flow1. ASD2. VSD3. AVC4. PDA
Obstruction of blood flow from ventricle
1. Pulmonary stenosis2. Aortic stenosis
3.Coarctation of the Aorta
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CONGENITAL HEART DISEASE
• Defects with increased pulmonary blood flow– Ventricular Septal
Defect• Opening between
ventricles• S/S
– 4-8 weeks, fatigue and harsh murmur
• Therapeutic management– Most close spontaneously
(small ones). Other larger VSDs may require open heart surgery
• Defects with increased pulmonary blood flow– Atrial Septal Defect
• Opening between the atria
• S/S– Murmur
• Management– Surgery
A trial Sepal Defect (ASD)
**Obstruction of blood flow from ventricle
1.Pulmonary stenosis
2.Aortic stenosis
3.Coarctation of the Aorta
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– Pulmonic Stenosis• Narrowing of the
pulmonary valve or artery causing the right ventricle to hypertrophy
• S/S– Mild right sided
heart failure
• Therapeutic Management
– Balloon angioplasty to relieve the stenosis
-Aortic Stenosis• Stenosis of the aortic
valve prevents blood from passing from the left ventricle into the aorta, leading to hypertrophy of the left ventricle
• S/S– Usually asymptomatic but
with murmur– May have chest pain and
even sudden death
• Therapeutic Management
– Stabilization with a Beta Blocker or Calcium Channel Blocker
– Balloon valvuloplasty– Valve replacement
– Coarctation of the Aorta
• Narrowing of the lumen of the aorta
• S/S– Absence of
palpable femoral &/or brachial pulses; headache, vertigo, nosebleeds, leg pain
• Therapeutic Management
– Surgery or angiography
Coarctation of the Aorta
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Cyanotic Heart Defect
Cyanotic
Decreased pulmonary blood flow Mixed blood flow
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**Defect with Decreased pulmonary blood flow
1. Tricuspid Artesia
2. Tetrology of Fallot
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– Tricuspid Atresia• The tricuspid valve is
completely closed, allowing no blood to flow from the right atrium to the right ventricle.
• When these structures close, cyanosis, tachycardia, and dyspnea occur.
• Treatment consists of an IV infusion of PGE (prostaglandin) to keep the ductus open until surgery can be performed.
Tetrology of Fallot (TOF)
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– Tetralogy of Fallot
• Four anomalies
– Pulmonary stenosis
– VSD
– Dextroposition of the aorta
– Hypertrophy of right ventricle
• S/S
– Cyanosis
– Polycythemia (increase in number of RBC)
– Dyspnea, growth restriction, clubbing of fingers
• Therapeutic Management
– Surgery