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Pediatric Cardiovascular System

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Question Answer
_______ output is a good indicator of cardiac output.
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Urine output
What assessment findings might you find in the respiratory system that would indicate a cardiac problem?
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Tachypnea, crackles (from fluid build-up related to congestive heart failure), wheezing, grunting, history of frequent respiratory infections.
What assessment findings in the integumentary system might be observed in a child with cardiac problems?
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Edema, cyanosis, clubbing
Prominence of the precordial chest wall is often seen in infants and children with __________.
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Cardiomegaly
A femoral pulse that is weak or absent in comparison to the brachial pulse is associated with what cardiac condition?
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Coarctation of the aorta
A bounding pulse is characteristic of what two heart conditions in infants or children?
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Patent ductus arteriosus or aortic regurgitation
A narrow or thready pulse may occur in children with ________ or _________.
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Heart failure or severe aortic stenosis
When palpating a child's abdomen you note hepatomegaly. You know this can be a sign of what cardiac problem?
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Right-sided heart failure
What heart sound is always associated with cardiac abnormalities?
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S4
What information can be gleaned from radiological studies (X-ray) related to the heart?
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Heart shape, size, position, configuration and blood flow pattern
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What nursing intervention is important when preparing a child for an X-ray?
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Make sure a gonadal shield is in place to preserve potential fertility
What information can be gleaned from electrocardiography (ECG) regarding the heart?
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Electrical function, rate, rhythm. It can detect underlying dysrhythmias/conduction disturbances, hypertrophy of the ventricles, and if using a 12-lead, how the heart is lying in the chest wall.
This diagnostic study can provide information regarding electrical function, rate, rhythm. It can detect underlying dysrhythmias/conduction disturbances, hypertrophy of the ventricles, and if using a 12-lead, how the heart is lying in the chest wall.
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Electrocardiography (ECG)
For a child who has continuous monitoring via ECG, what intervention can you perform to prevent skin breakdown?
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Rotate the lead patches every 24-48 hours
What are the nursing implications for a child undergoing an ECG?
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Distract the child long enough to get a snapshot of heart function, instruct them not to pull on the leads
What are some important teaching points for a child wearing a Halter moniter?
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Don't get it wet, don't take it off, if an electrode pops off, put it back on.
If a child is ________, an ECG won't be accurate
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Crying
What can be ascertained using a 2-D Echocardiogram?
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Structural problems related to the size/shape of the heart, structural abnormalities, (especially valvular diseases), blood flow & velocity (and turbulence)
T/F A tranthoracic echocardiogram is an invasive diagnostic tool used to assess cardiac structures, detect valvular disease, and measure blood velocity.
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False, A tranthoracic echocardiogram is a non-invasive diagnostic tool used to assess cardiac structures, detect valvular disease, and measure blood velocity. It is very similar to an ultrasound
What is a complication related to getting an accurate Echocardiogram for a child?
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They have to lay still during the test.
A baby has been sedated in order to get an Echo. What medication was most likely used and what are the nursing implications of this?
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Versed. The baby needs to be monitored every 15 minutes from the administration of the drug and for at least 1-2 hours post-procedure.
  
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