Galen College of Nursing NUR 230 Exam 3 (Peds) Study Guide 2022
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.
Galen College of Nursing NUR 230 Exam 3 (Peds) Study Guide 2022 Galen College of Nursing NUR 230 Exam 3 (Peds) Study Guide 2022
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
▪Antibitoics
▪Anti-inflammatories
Galen College of Nursing NUR 230 Exam 3 (Peds) Study Guide 2022 Galen College of Nursing NUR 230 Exam 3 (Peds) Study Guide 2022
▪Bedrest.
Galen College of Nursing NUR 230 Exam 3 (Peds) Study Guide 2022 Galen College of Nursing NUR 230 Exam 3 (Peds) Study Guide 2022
•Kawasaki Disease:
oEtiology is unknown, though nor known to spread from person to person it is seen in geographic
and seasonal outbreaks.
oMucocutaneous lymph node syndrome.
oAcute systemic vasculitis of unknown cause
o%75 of cases are children under age 5
oSelf-limiting
oIncreased risk of coronary artery aneurysm
oAcute Phase – Abrupt high fever not responsive to antibiotics, irritability, rash, red eyes, peeling hands and feet, irritability, red tongue.
oSubacute phase – Resolution of fever and lasts until all clinical signs of KD have disappeared. This phase is where the child is at greatest risk for developing
coronary artery aneurysms.
oConvalescent phase – All signs and symptoms have resolved but lab values remind abnormal until around 6-8 weeks later.
oTreatment
▪Globulins
▪Aspirin
oNursing interventions
▪Light weight clothing
▪Monitor temperature
▪Nutrition: Bland foods, avoid citrus or other irritating foods.
Galen College of Nursing NUR 230 Exam 3 (Peds) Study Guide 2022
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.
Galen College of Nursing NUR 230 Exam 3 (Peds) Study Guide 2022 Galen College of Nursing NUR 230 Exam 3 (Peds) Study Guide 2022
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
▪Antibitoics
▪Anti-inflammatories
Galen College of Nursing NUR 230 Exam 3 (Peds) Study Guide 2022 Galen College of Nursing NUR 230 Exam 3 (Peds) Study Guide 2022
▪Bedrest.
Galen College of Nursing NUR 230 Exam 3 (Peds) Study Guide 2022 Galen College of Nursing NUR 230 Exam 3 (Peds) Study Guide 2022
•Kawasaki Disease:
oEtiology is unknown, though nor known to spread from person to person it is seen in geographic
and seasonal outbreaks.
oMucocutaneous lymph node syndrome.
oAcute systemic vasculitis of unknown cause
o%75 of cases are children under age 5
oSelf-limiting
oIncreased risk of coronary artery aneurysm
oAcute Phase – Abrupt high fever not responsive to antibiotics, irritability, rash, red eyes, peeling hands and feet, irritability, red tongue.
oSubacute phase – Resolution of fever and lasts until all clinical signs of KD have disappeared. This phase is where the child is at greatest risk for developing
coronary artery aneurysms.
oConvalescent phase – All signs and symptoms have resolved but lab values remind abnormal until around 6-8 weeks later.
oTreatment
▪Globulins
▪Aspirin
oNursing interventions
▪Light weight clothing
▪Monitor temperature
▪Nutrition: Bland foods, avoid citrus or other irritating foods.
Galen College of Nursing NUR 230 Exam 3 (Peds) Study Guide 2022
